New account

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There are required fields in this form marked .

If you had an account in the past please do not use this form, go to: Update my existing account

If you don't have a work email for your sole use, provide a private personal email address.
If you are a student, use your student email.
Fill in as many fields as you can. If you have not supplied sufficient information, your account request may be declined.

Email address and password

Work email address (lowercase letters)

Retype email address

The password must have at least 12 characters, at least 1 digit(s), at least 1 lower case letter(s), at least 1 upper case letter(s)

Password

Unmask

About you

First name

Surname

City/town

Country

Security challenge

Select your main district

Choose the location you most often work in or where your study placement is.

Click to see a map of districts

Select a position

Choose the position that best describes your work.

Work setting (facility or environment you work in)

If you are a student, what is your field of study?

Employer name

Job title

Team

Employee Number if at Health New Zealand

Registration or application information

HPI / CPN Number (Health Provider Index)

Allied and Scientific registration or application number

Medical registration or application number

Midwifery registration or application number

Nursing registration or application number

Overseas applicants

If you have applied for registration with a New Zealand clinical registration authority, please tick to confirm you have provided your registration number in the relevant field above.

If applying for a job in New Zealand, please tick to confirm you have provided the employer name in the field above.

Administration

Account request note