Halswell health 2025

1. Click ‘Get Form’ to open the halswell health Patient Enrolment Form in the editor.
2. Begin by filling out the 'Patient Information' section. Enter your surname, first name(s), preferred name, and date of birth. Select your title (Mr/Mrs/Ms/Miss/Mast) and provide your maiden name if applicable.
3. Complete the gender, occupation, and NHI fields. Indicate whether you have a Community Services Card or High User Health Card.
4. In the 'Contact Details' section, provide your physical address, postal address (if different), and contact numbers including home, work, and cell phone.
5. Fill in the 'Next of Kin' and 'Emergency Contact Details' sections with names and contact numbers.
6. Indicate your smoking status and whether you would like assistance to stop smoking.
7. Confirm your New Zealand citizenship status and complete any additional eligibility criteria as required.
8. Review all information for accuracy before signing at the bottom of the form. Ensure you understand the terms of trade and privacy statement.

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