Get Rec12 - Authorisation To Disclose Information Form - Non Caregiver

Filling out the REC12 - Authorisation To Disclose Information Form - Non Caregiver online is an important step in authorizing the disclosure of information to Healthcare of New Zealand Limited. This guide will provide you with clear instructions on how to complete each section of the form efficiently.

Follow the steps to complete the form accurately.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor. This will allow you to access the necessary fields and sections needed for completion.
2. Begin by entering your surname and first names in the designated fields. Ensure that your names are spelled correctly as they appear on official documents.
3. If you have any maiden names or other names used in the past, enter them in the corresponding field to provide full disclosure of your identity.
4. Select your sex by marking the appropriate box for Male (M) or Female (F) in the relevant section.
5. Fill in your date of birth and place of birth. Make sure the information is accurate as it can be used for identification purposes.
6. Indicate your nationality in the provided field to clarify your citizenship status.
7. Enter your residential address, ensuring that all components, such as street number, street name, suburb, and city, are correct.
8. Provide your New Zealand Driver Licence number in the specified area. This is important for identity verification.
9. Review the authorization statement carefully. By signing, you are allowing disclosure of any information relating to your interactions with the New Zealand Police to Healthcare of New Zealand Limited.
10. Sign and date the form to validate your authorization. Make sure the date is current.
11. Finally, save your changes, and choose to download, print, or share the completed form as needed for your records or submission.

Take the next step in your process by completing the REC12 form online today.