West Coast DHB Official Information Act Request Form

1OIA Request Details

2Your contact details

Subject
Please provide a brief description of your requested information.
Information requested*
Please ensure your request is as clear and specific as you can make it. The information you request, along with the West Coast District Health Board's response, may be published on this website. Please be assured that should we publish your OIA request, all of your personal details will be withheld. Only New Zealand citizens, permanent residents, those currently in New Zealand or companies registered in New Zealand may apply.
File
Please note: The maximum allowable file size per form submission is 8 MB
Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 8 MB, Max. files: 3.

Your Full Name*
I'd like to be contacted via...*
Please indicate which of the following is your preferred way of being contacted (This will make your option compulsory to enter and will ensure we have the info we require to getting back to you).
- Email
- Postal Address
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City ZIP / Postal Code Country
Email
Enter Email Confirm Email
Address
Street Address Address Line 2 City ZIP / Postal Code Country
Phone

Page last updated: 20 April 2021

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