215 Wairau Road, North Shore, Auckland 0627 / 09 4448682
My declaration of entitlement and eligibility
(for public funding)
Patient CODE of CONDUCT
1. I shall treat staff with respect2. I acknowledge that each appointment slot is in 15 minutes 3. If I am late for an appointment I understand I will have to reschedule the appointment4. I understand that if I miss my appointment or do not present to my appointment without prior notification of at least 90 minutes, I will be charged a full consultation fee5. I will present no more than two problems at each consultation6. Clinical staff will prioritise and defer some presented problems to a further appointment time7. If I run over time due to expectation of covering more problems, I will pay an extra fee for extra time8. I will also pay for any extra charges as determined with the staff including but not limited to ECG, injections, cervical smears, excisions, liquid nitrogen 9. I will pay in full for my consultation on the day if not arranged by prior approval with reception10. Any reduced fee differences to those published is at the discretion of staff11. If I lose a current prescription it is at the discretion of staff to provide another prescription which will be paid for 12. If I have any problems or difficulties with the clinic or staff conduct I will report this immediately by, but not limited to, filling in a complaint form or directly discussing with staff
Please note the clinic and staff are guided by the Health and Disability Commission's PATIENT RIGHTS.
By completing and signing this registration form you acknowledge these codes. If you do not agree please do not continue.