Registration for New Zealand medical exam
Please send us a completed form before making an appointment.
A separate form is required for each family member.
We will use email if we cannot reach you by phone. Personal email address is preferred
Canadian or US number only. Local phone number preferred. This is needed to contact you if additional tests are required or other problems occur,
Format: 10 digits without spaces or hyphens.
Local address is preferred, even if it is not permanent.
Date format: dd/mm/yyyy
(numeric day, month and full year separated by periods)
A valid passport is always preferred. A copy of the passport is acceptable but then you will also have to show us another picture ID. A passport that is expired for less than one year may also be acceptable.
If you have no passport, a national ID card or a Canadian driver's license may be acceptable.
INZ Reference Number
If you have already applied for NZ immigration you probably have this number.
If you are doing an "upfront" medical you probably do not have this numbert. If you don't, leave this box blank.