Book an Appointment — Access Relief

New Patient Registration

Complete this form to request an initial consultation. We'll confirm your appointment by phone or email within 1 business day.

It looks like you may already be a patient with us. It looks like we may already have your details on file. If you're an existing patient, please call us on 09 242 4565 or SMS 021 157 6741 to book a follow-up. You can still submit this form if you believe this is incorrect.

Your Details

First Name *

Last Name *

Date of Birth *

Mobile Number *

Email Address *

Delivery Address

Start typing your street address and select from the suggestions.

Street Address *

Suburb

City *

Postcode

Your Condition

What are you seeking treatment for? *

Current GP / Doctor (if any)

How did you hear about us?

Consultation Preference

Preferred practitioner

Preferred consultation type

Consent

I consent to Access Relief collecting and using my personal and health information to provide medical services. I understand my information is protected under the Health Information Privacy Code.

I agree to be contacted by phone, SMS, and email about my appointment and treatment.

By submitting this form you confirm you are aged 18 or over and a NZ resident. Access Relief is a telehealth medicinal cannabis clinic. Appointments are subject to eligibility assessment.

✅

Request received!

Thank you — we'll be in touch within 1 business day to confirm your appointment.

If you have an urgent question, call us on 09 242 4565 or SMS 021 157 6741.

Access Relief — Book an Appointment

New Patient Registration

Request received!