Refer a patient to our expert orthotics or amputee services team; we provide support, rehabilitation, products and care across New Zealand.

 

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Referral Form

Peke Waihanga Amputee Referral Form Preview

Use this form to refer an amputee to Peke Waihanga - Artificial Limb Service.

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Referral Form

Peke Waihanga Orthotic Referral Form Preview

Use this form to refer a patient to Peke Waihanga - Orthotic Service.

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Order Form

NZALS Amputee Stump Shrinker Form Preview

Use this form to order a stump shrinker for a Below or Above Knee amputee.

Download (PDF) ⏷