Rapid Enrolment Service

Use this kiosk to enrol with Anglesea Partner Practices, or scan the QR code below with your phone to enrol on your phone.

Get Started

Is the person being enrolled permanently residing in New Zealand?

The definition of permanently residing in New Zealand is: is that the person being enrolled intends to be resident in New Zealand for at least 183 days in the next 12 months

The patient being enrolled is eligible if they meet any of the following criteria:

  1. holds a resident visa or a permanent resident visa (or a residence permit if issued before December 2010)
  2. is an Australian citizen or Australian permanent resident AND able to show they have been in New Zealand or intend to stay in New Zealand for at least 2 consecutive years
  3. has a work visa/permit and can show that they are able to be in New Zealand for at least two years (previous permits included)
  4. is an interim visa holder who was eligible immediately before an interim visa started
  5. is a refugee or protected person OR in the process of applying for, or appealing refugee or protection status, OR a victim or suspected victim of people trafficking
  6. is under 18 years and in the care and control of a parent/legal guardian/adopting parent who meets one criterion in clauses a–e above OR in the control of the Chief Executive of the Ministry of Social Development
  7. is a NZ Aid Programme student studying in NZ and receiving Official Development Assistance funding (or their partner or child under 18 years old)
  8. is participating in the Ministry of Education Foreign Language Teaching Assistanship scheme
  9. is a Commonwealth Scholarship holder studying in NZ and receiving funding from a New Zealand university under the Commonwealth Scholarship and Fellowship Fund
I confirm that, if requested, I can provide proof of the patient's eligibility
  • To view service eligibility, visit myeligibility.anglesea.co.nz
  • To view our Privacy Policy & Health Information, visit myprivacy.anglesea.co.nz

Enrolment

Patient name

Patient details

Patient address

Patient contact details

Next of kin

Patient cards (optional)

Finish

Select Clinic

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  • Enter address to list clinics

You are enrolling with

Agreement

I intend to use these providers as my regular and on-going provider of general practice / GP / health care services.

I understand that by enrolling with I will be included in the enrolled population of , and my name address and other identification details will be included on the Practice, PHO and National Enrolment Service Registers.

I understand that if I visit another health care provider where I am not enrolled I may be charged a higher fee.

I have been given information about the benefits and implications of enrolment and the services this practice and PHO provides along with the PHO's name and contact details.

I have read and I agree with the Use of Health Information Statement. The information I have provided on the Enrolment Form will be used to determine eligibility to receive publicly-funded services. Information may be compared with other government agencies, but only when permitted under the Privacy Act.

I understand that the Practice participates in a national survey about people's health care experience and how their overall care is managed. Taking part is voluntary and all responses will be anonymous. I can decline the survey or opt out of the survey by informing the Practice. The survey provides important information that is used to improve health services.

I agree to inform the practice of any changes in my contact details and entitlement and/or eligibility to be enrolled.

Signing

Please sign using the touch screen.

Authority Details

An authority has the legal right to sign for another person if for some reason they are unable to consent on their own behalf.
You are done!