ONLINE REFERRAL

Please complete the below online referral form, after which you will receive a confirmation email. We will then be in touch to conduct a 15-minute screening appointment by phone or in person to verify your eligibility for the service.

Please read the following before completing this form to ensure you are eligible for our free service.

To qualify for our free service, you must meet all of the following criteria:

• Be between 16 and 64 years of age

• Be a New Zealand citizen, permanent resident, or refugee

• Have a self-identified physical or mental health condition or disability that is likely to last longer than six months

• Be currently unemployed or working less than 5 hours per week

• Not be signed up with another provider

• Not be receiving ACC payments

Personal Details

Emergency Contact

Other Support Agency Information

Other Important Information

Please Read our Code of Conduct

Code of Conduct Agreement

I have read and agree to abide by the ‘employable’ Code of Conduct for clients.

PRINCIPLES:

To establish guidelines for acceptable behaviour to protect the health, safety, and welfare of ‘employable’ staff, clients, and visitors. Any behaviour that interferes with the basic purposes and processes of the Trust, or disregards the health, safety, and rights of staff, visitors, or members of the community, is unacceptable.

Please note: ‘employable’ operates a zero-tolerance violence policy. Any acts of aggression will result in immediate termination of services with ‘employable.’

GENERAL:

While accessing the ‘employable’ premises and services, clients and visitors:

• Will respect other people.

• Will not verbally, physically, or psychologically abuse or intimidate others.

• Will respect the property of others.

• Will not smoke.

• Will not consume drugs or alcohol (alcohol may be served at special events).

• Will not carry prohibited and/or dangerous articles/weapons.

• Will follow all reasonable instructions given to them by ‘employable’ staff members or Trustees.

  
  

POST-JOB PLACEMENT SUPPORT:

I agree that ‘employable’ may continue to support me for a minimum of 3 months after successfully securing employment through ‘employable’ services. I authorise ‘employable’ staff to contact my employer, emergency contact, or Work and Income to verify placement details.

SCREENING:

Following my enrolment appointment, ‘employable’ will conduct a screening process for 5 weeks. During this period, ‘employable’ will work with me on a voluntary basis and will not apply for Ministry of Social Development (MSD) funding. If I fail to attend appointments, provide relevant information, exhibit aggressive or inappropriate behaviour, or otherwise do not align with the service provided, ‘employable’ may choose not to apply for funding on my behalf. This process ensures MSD funding is secured only for genuine and motivated job seekers.

HEALTH AND SAFETY:

Clients and visitors are required to observe any lawful directions given by an ‘employable’ staff member, in line with the Health and Safety at Work Act 2015 and ‘employable’s Policies & Procedures.

FAILURE TO KEEP APPOINTMENTS:

‘Employable’ reserves the right to restrict access to services for clients and visitors who regularly fail to notify ‘employable’ of appointments they are unable to attend or fail to respond to correspondence. If a client cannot attend an appointment, it is their responsibility to let ‘employable’ know. This can be done via phone call, text, or email. By enrolling in the service, the client agrees to attend all planned appointments and take responsibility for ensuring they make weekly contact with ‘employable’ (unless alternate agreements have been mutually made).

CONSEQUENCES OF BREACHING THE CODE OF CONDUCT:

Where, in the opinion of ‘employable’ staff, there has been a breach of this Code:

The client/visitor will be asked to cease their unacceptable behaviour immediately, and the appropriate referral/support agencies will be notified. If the client/visitor refuses, by expression or action, the staff member may:

• Terminate the phone call.

• Instruct the client/visitor to leave the premises.

• Exit the vehicle and immediately contact the ‘employable’ Manager for instructions.

• Continued or severe disruptive behaviour or failure to comply with a reasonable instruction may require the staff member to call for Police assistance.

Please note: Where a client/visitor has repeatedly or seriously breached this Code of Conduct, ‘employable’ reserves the right to refuse access to its services & premises in the future.

Provisions under the Privacy Act 2020

Client Consent and Privacy

By enrolling with ‘employable,’ clients provide general consent for our staff to contact their employer, emergency contacts, emergency services, or relevant support organisations when deemed necessary by ‘employable’ staff, to assist the client or verify relevant information related to their service. This consent is based on professional judgment and must not be re-affirmed for each instance. Clients should understand that such contacts are made only when appropriate and in the best interest of the client’s well-being and service outcomes.

We are committed to protecting the privacy of our clients and operate in full compliance with the Privacy Act 2020. Any personal or sensitive information shared by clients with our staff will be treated confidentially and used solely for the purpose of delivering services. Staff may collaborate and share relevant client information amongst themselves, as part of our operational procedure, to ensure all aspects of the client's service are coordinated effectively. This sharing is conducted in line with the principles of the Privacy Act and is not a breach of privacy, as it is done within the scope of providing effective support to the client.

If the primary consultant is unavailable, a backup staff member will be assigned to manage the client’s case to ensure continuity of service without compromising the client’s privacy or confidentiality.