For the purposes of providing occupational health and safety services, your employer/potential employer has asked NZProvide to collect your personal information. In collecting, accessing, using, handling and disclosing your personal information, NZProvide will at all times comply with the Privacy Act 2020 (NZ) and the Health Information Privacy Code 1994 (NZ) and all other relevant legislation as applicable in New Zealand from time to time. NZProvide will also comply with its own privacy policy, a copy of which is available at:

Personal information is any information about an individual from which their identity may reasonably be ascertained. The personal information NZProvide intend to collect from you includes (but may not be limited to) your name, date of birth, address, contact details and information regarding your health relevant to the services being provided to you or employer/potential employer. These services may include:

  • Pre-employment medical examinations;
  • occupational annual health monitoring checks;
  • specific event occupational health monitoring checks; and
  • targeted health and safety prevention programmes.

The ‘Primary Purpose’ of collecting your information is to provide you with any of the above services, or any other occupational health and safety service we may provide. Except as required by law, your personal information will not be used or disclosed to any third party without your prior consent other than for its intended Primary Purpose. Third parties to whom the information may be disclosed to effectively assist us in providing the Primary Purpose include:

  • yourself;
  • your employer;
  • the person/company referring you to NZProvide; and
  • any other third party associated with the service being provided to you (e.g. nominated treating doctor; other treating medical practitioner; employer representative or agent).

If the personal information is not provided by you, we may be unable to provide you or the party that has engaged us with the requested services. NZProvide ensures that your personal information is stored securely and is only accessible by authorized employees.

For any queries regarding this Privacy and Consent statement or for further information regarding the way NZProvide handles personal information, please contact 0508 697 768 (NZ) 1800 210 971 (Australia) or email


I authorise NZProvide on behalf of my employer/potential employer, or any other party referring me to NZProvide, to obtain medical, health and other personal information that is relevant to the services being provided to me/my referring party by NZProvide. This may include (but is not limited to) such information as my name, age, address, contact details, gender, employment, health and medical information.

I understand that in the collection, use and storage of this information, NZProvide will at all times comply with the Privacy Act 2020 (NZ), the Health Information Privacy Code 1994 (NZ), NZProvide’s own Privacy Policy, and all other relevant legislation in force from time to time. I understand that in accordance with such legislation and policies, I have the right to access and alter any personal information about myself that NZProvide hold.

By providing my Personal Information to NZProvide, I consent to this information being disclosed by NZProvide or authorised agents of NZProvide to whatever third party NZProvide deems necessary to provide the Primary Purpose.

I understand that for NZProvide to provide the requested services to me/my referring party, I may have to undergo a medical, drug or alcohol test.

The authority is valid for the period of 24 months, starting from the date consent is given.