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Referring someone

Connect yourself or someone you know or work with to specialist support from Canteen

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We need a few details so that we can provide you with the best possible support. Once you submit the form, someone from the Canteen Services team will be in touch as soon as possible (within 5 working days) to discuss support options. Please note that Canteen does not provide a crisis service. For emergencies, please contact 111 or for mental health advice and support please free text 1737.

Please select if you are...

Rangatahi Details

Are you 18 years or older?

Emergency Contact Details

Rangatahi Cancer Experience

Referrer Details

Rangatahi Details

Rangatahi Consent

Rangatahi Emergency Contact

Rangatahi Cancer Experience

Referrer Details

Rangatahi Details

Rangatahi Consent

Rangatahi Emergency Contact

Rangatahi Cancer Experience

IMPORTANT NOTE:

Due to a technical issue, we were unable to retrieve any submission data sent between 1–8 July 2025.

If you submitted a form or enquiry during this time, please get in touch with us directly so we can make sure your information is received. You can contact us at info@canteen.org.nz or call 0800 2268 336.

We’re sorry for the inconvenience and appreciate your understanding.