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Patient Admission Form


Patient admission forms for Mercy Hospital and Manaaki by Mercy are available here.

Please return your completed admission form as soon as possible by one of the methods indicated below. 

If your surgery is at Mercy Hospital use this document
  Mercy Hospital Patient Admission Form


then return:


If your surgery is at Manaaki by Mercy use this document

  Manaaki by Mercy Patient Admission Form


then return:


OR return:

  • by post to Mercy Hospital Dunedin Limited, Private Bag 1919, Dunedin 9054

  • by handing in the form to our Reception at 72 Newington Avenue, Dunedin. 

If returning by email then we will ask you to sign the form when you attend.