Follow the steps to accurately complete your enrolment form.

1. Press the ‘Get Form’ button to access the Riccarton Clinic Enrolment form and open it in your preferred editor.
2. In the title section, input your first name and family name, ensuring both fields are completed as they are required.
3. Provide additional names if applicable, such as other names you are known by or your preferred name.
4. Indicate your gender by selecting either male or female.
5. Fill in your physical address, including your street number, suburb, city or town, and postcode.
6. Record your date of birth in the specified format (day, month, year).
7. If applicable, provide your Community Services Card details, including card number and expiry date.
8. Enter your postal address if it differs from your physical address.
9. Complete your contact details by including day, night, and cell phone numbers, as well as your email address for communication.
10. Select your preferred doctor if you have one.
11. Indicate your smoking status by circling the relevant option—never, current, ex-smoker, or not applicable.
12. Identify your ethnic group by marking one or more boxes that apply to you.
13. Grant consent for the practice to obtain your medical records by providing your previous doctor's name and address.
14. Confirm your eligibility for enrolment by circling the appropriate criteria that applies to you.
15. Read and agree to the terms and conditions by signing and dating the form, including your parent or caregiver’s signature if you are under 16 years old.
16. Finally, save your changes, download, or print the completed form as needed for your records.

Complete your Riccarton Clinic Enrolment form online today for timely access to health care services.