Enrolment

Below are copies of our downloadable forms for enrolment at Flagstaff Medical Centre. To enrol with us please print the forms and bring these into the clinic or alternatively you may scan and email these to [email protected]

Enrolment Form - One form per person must be completed.

Screening Form - To be completed for each person over 16 years old.

Transfer of Records Request Form - Each person over the age of 16 must complete and sign their own form. Children under the age of 16 can be included on the parents form.

Please note if you were born outside of New Zealand we do require a copy of your Visa/NZ Passport or NZ Citizenship documentation.

 
Photo of the front of the Flagstaff Medical Centre