Sign up your practice

If you know you want to start using our services, please fill out this form with your practice details, and we'll get your practice set up, then contact you for any extra information we might need. Your first month is free.

Contact Details

This is the email where completed enrolment forms will be sent
What email would you like to be displayed on the completed enrolment form? This is the email other practices will use to contact you
We use this to link to your practice from the enrolment form. If your practice doesn't have a website, you might want to use your Healthpoint page

Practice Address

Administrative Details

The primary health organisation with which your practice is associated
This will be used on the form if no practitioner is specifically chosen.
This means that previous practices can still send records.


Prevent unrestricted enrolments by requiring patients to provide a code which your practice admin staff can generate.
TIFF files can be easily integrated with MedTech32, unlike PDF files.
Make it compulsory for new patients to enter an email address which you can use to contact them
Add a required step to the form to collect the occupation of new patients.
Require patients over one year old who do not have a Community Services Card to provide evidence of their identity and eligibility to enrol.
Please note that this measurably decreases completion rates and is likely not required for many patients, whose NHI record will already show their eligibility.
Ask patients about their smoking status during enrolment.


Offer patients the chance to choose to enrol with a particular doctor or nurse practitioner
You can add practitioners here if you want patients to be able to choose to enrol with a particular practitioner. If you leave the NZMC field blank, the default NZMC field will be used.

Practitioner 1

Practitioner 2

Practitioner 3

Practitioner 4

Practitioner 5

Practitioner 6

Practitioner 7

Practitioner 8

Practitioner 9

Practitioner 10