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Brought to you by Health New Zealand | Te Whatu Ora – Southern and WellSouth primary health network

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Te Whatu Ora Southern Oral Health Enrolment Form

Te Whatu Ora Southern Oral Health Enrolment

Children who meet the eligibility criteria for publicly funded health and disability services are entitled to free oral health care from birth until their 18th birthday.

Complete the form below to enrol your child or to update contact details.

Fields marked with * are required.

  • Current Personal details of your child
  • Other children
  • Parent / guardian 1
  • Parent / guardian 2
  • Alternative contact details
  • Comments
  • Complete
Child's address
Postal address if different from above