CALL US: 09 834 6300  |  382 Te Atatu Rd, Auckland, New Zealand
Enrolling

Enrolling With Us

To become a patient at Peninsula Medical Centre, you need to fill in the form below for each patient enrolling and return the originals to us:
 

  • Enrolment Form
    • One form per patient enrolling is required
    • This form requires you to complete information about yourself, including contact details, next of kin, ethnicity and your previous medical centre (so we can obtain your medical notes), as well as a declaration of your eligibility and agreement to enrol.

 

Completing the Form

There are certain requirements for eligiblity, so please read the following carefully:
 

  • You must confirm your eligibility to access publicly funded health services and we ask that you provide proof of eligibility, such as a passport or birth certificate.
  • Children 16 and over must sign their own enrolment form.
  • In order to enrol you, we require original completed copy of the above form for legal reasons 

 

For more information on eligibility, check out the Ministry of Health's Guide to Eligibility for Publicly Funded Health Services.

 

Opening the above form: You may need to have Adobe Acrobat Reader installed on your computer to open the above form. You can download this for free here.