04 384 4315
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Level 2 / 61 Taranaki Street
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Call Port Nicholson Medical 04-384 4315 for an appointment
Port Nicholson Medical
Level 2
61 Taranaki Street
Te Aro
Wellington, 6011
Phone: 04 384 4315
Email:
[email protected]
Opening Hours
Monday: 8am - 5:00pm
Tuesday: 8am - 5:00pm
Wednesday: 8am - 5:00pm
Thursday: 8am - 5:00pm
Friday: 8am - 4:30pm
Weekends & Public Holidays : Closed
Contact Form
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If you would like to request a prescription, please either request this through Manage My Health or phone reception on 04 384 4315. Please note that we do not take repeat prescription requests via email.
New Patient Application
If you are interested in becoming a patient at Port Nicholson Medical Centre please fill out this application form and we will assess our capacity to take you on as a new patient.
Please note this is not an enrolment form
, if we are able to take you on as a new patient we will be in contact and will send you an enrolment pack to complete.
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Name
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Date of birth
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Email
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Phone number
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Gender
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Do you have a current GP in Wellington?
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What is your current residency status?
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Are you a current NZ citizen or have residency in NZ? If not where do you have residency?
What is your ethnicity?
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What is your current smoking status?
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Current smoker
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How many standard drinks do you typically consume per week?
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1 small glass of wine OR 330ml can/bottle of beer OR 1 nip of spirits = 1 standard drink
Are you on any regular medications?
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If yes, please list with doses and frequency if possible
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Do you have an allergy to any medication or significant reactions to any other substance?
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If yes, please list these medications
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Past medical history: please give a brief summary of any long-term or serious health conditions you have or have had including major surgeries
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Family history: do any of your immediate family (parents and siblings) have any serious health conditions including diabetes, heart disease or any type of cancer? Please give details
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Any other queries or information you would like to include?
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