Your Profile

In order to access a  secured section for allied heath professionals including referring a patient to the Kathleen Kilgour Centre you will need to register for login details. We will review your information and email you to confirm when you have an active account and can start referring (if applicable).

Please note:
The Kathleen  Kilgour Centre requires a working email address to be included as a condition of using this website. Your email address will ONLY be used to notify you when your account has been approved and when you have a message awaiting your attention. Your email address will NOT be shared outside of this website.

If you use this site, you are responsible for maintaining the confidentially of your account and password, and you agree to accept responsibility for all activities that occur when you are logged into your account.

Title*
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First Name*
Last Name*
Email*
Clinic Address
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Job Title
Contact Telephone
Clinic Telephone (if applicable)
In order to facilitate referral rights please select your professional role
Medical Council of NZ number (if applicable)

By submitting this form, I confirm that I am a licensed, practising health professional.

 

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Password*
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Confirm Password*

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