Patient Form’s

 

 

 

 

Aclasta Referral

This for is for medical practitioners who wish to refer patients to the Hamilton East Medical Centre Infusion Centre for Aclasta. Please download, complete this form and return to Hamilton East Medical Centre.

  Aclasta GP Referral Form

Automatic payments

Complete and return to your bank to arrange an automatic payment of existing and future medical costs.

 Automatic Payment Form

New patients

To enrol with us please complete and return to Hamilton East Medical Centre.

  Enrolment Form

If you were born outside of New Zealand, please provide proof of residency or a working visa endorsement.

Australian citizen’s or Australian permanent resident’s also need to provide proof that they intend to stay in New Zealand for at least 2 consecutive years.

Once all of the originals have been sighted and verified by our reception staff, we can then book you in for your first appointment.

Transferring medical records from another doctor/clinic

Please complete and return to Hamilton East Medical Centre.

  Transfer medical records form

  Please click here to see a list of our doctors who are taking on new patients.

Health Information Privacy Statement

  Health Information Privacy Statement

Travel questionnaire

Complete this form before coming to visit our Travel Doctor.

  Travel Questionairre

PADI Dive Medical

Please complete and return before making your Dive Medical appointment.

  PADI dive medical form

Patient complaint form

  Patient complaint form

Find us

16 Beale Street, Hamilton East
Hamilton 3216

Contact us

Postal Address
PO Box 4096, Hamilton 3247

07 839 1232
07 834 0928
hemc@hemc.co.nz

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