Change of Details

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If you are a patient registered with with East Tamaki Healthcare, please use the form below to let us know your change of details. Alternatively, you can contact our Call Centre on 274 7823 or tell the receptionist next time you visit your clinic.

We value your privacy. All information submitted on the form below will be treated as confidential.

Change of Details Form

Current Details

1. Surname
2. First Name
3. Preferred Name
4. Street
5. Suburb
6. City
7. Postcode
8. Contact Phone
9. Mobile Phone
10. Medical Centre
11. Sandringham Airport Oaks Bairds Rd Dawson Rd Glen Innes Otara Mall Chapel Park East Tamaki Mangere Town Centre Dannemora Manurewa Sylvia Park

New Details

1. Surname
2. First Name
3. Preferred Name
4. Street
5. Suburb
6. City
7. Postcode
8. Contact Phone
9. Mobile Phone
10. Medical Centre
11. Sandringham Airport Oaks Bairds Rd Dawson Rd Glen Innes Otara Mall Chapel Park East Tamaki Mangere Town Centre Dannemora Manurewa Sylvia Park

Other details

1. Other

 

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