Email Appointment Form

Email Appointment Form

Kia ora, soon you will be able to see the Nurse or your GP’s calendar and book an appointment immediately online. In the meantime, please indicate below when you would like to see the doctor or nurse. You will receive a reply by email or text within the same business day to confirm your appointment.
Full Name *

First Name Last Name
Date of Birth *

Day Month Year
Date Date Picker Icon
Mobile Number
Email
example@example.com
Who do you want an appointment with? *

Practice Nurse Gene Hill Dr Joe Bourne Dr Tim Chiari Dr Melanie Stephen Dr Jennifer Hall Dr Dan Jackson Any available doctor Asthma and Respiratory Coordinator Diabetes Nurse Tamariki Ora Well Child Nurse Lactation Breastfeeding Consultant (from 1 July 2019) Alcohol and Drug Counsellor Mental Health Practitioner
Preferred times (please tick all that you can make): *

Monday AM Monday PM Tuesday AM Tuesday PM Tuesday PM EVENING (for all non-GP services above) Wednesday AM Wednesday PM Thursday AM Thursday PM Friday AM Friday PM
Please note any further details about your appointment.
(for example - immunisation for daughter Miria Maxwell-Crawford, if possible after school any time after 3pm)
Should be Empty: