Immigration Medical Exam Booking Form

First Name(s) - as per passport

Last Name(s) - as per passport

Date of Birth

Gender

New Zealand Phone Number

Email

Street Number and Name

Suburb

City

PostCode

Country of Birth

Passport Number

Passport Issuing Country

Passport Date Of Issue

Passport Expiry Date

Exam Required (if unsure please contact New Zealand Immigration)

Chest Xray Required

Pacific Radiology

Chest x-rays are available at Pacific Radiology, Wanaka Lakes Health Centre (next door to the medical centre) Phone 03 4430700 - Please note additional charges apply and are payable to Pacific Radiology.

Visa Category

Proposed Occupation in New Zealand

Has Immigration NZ, contacted you regarding an existing Immigration Medical and requested more information ?

Please attach the information requested by Immigration NZ

Or please provide details of the information requested

New Zealand Address

Monday - Friday

Weekends and Public Holidays

After Hours

Email

Aspiring Medical Centre

Book an appointment

Repeat prescriptions

Request a GP call-back