Request for Personal Information

You can fill out the Request for Information Form if you:

• are a client of Whānau Āwhina Plunket
• are the parent or guardian of a child who is under 16 years of age
• have written consent from a client of Whānau Āwhina Plunket.

Before filling out the form, please make sure you can attach copies of:

• your photo identity
• proof of relationship (if required)
• details of any current orders in place in relation to the child (if applicable)
• written consent or lawful authority to act on the client's behalf (if applicable)

Requests from agencies and other organisations

If you are sending an information request on behalf of an agency, or any information request that is not a personal information request, please contact privacyinformationrequests@plunket.org.nz with your requested information and authority to request.

Requesting your own information

1. You can request your own information by completing the Release of Information Form.
2. Please include specific details of the information you require, including the dates and the documentation you require, e.g. discharge summary, clinical notes.
3. All requests must be accompanied by proof of identification with a photo and signature (e.g. drivers licence, passport).

Requesting clinical information for your child

1 - 3 as above. You may be asked for proof of relationship to the child.

Requesting clinical information for a relative or friend

1 - 3 as above, plus written consent from the client or, if applicable, a copy of the Power of Attorney.

Requesting clinical information for a deceased child

1-3 as above, plus consent from the Executor/Administrator of the Will. If there is no Will, we will require proof that you are the next of kin or the deceased person’s representative.

Click the button below to fill out the form. It will open in a new tab.

Request for Information Form

It may take up to 20 working days for us to respond to your request, however, all efforts are made to process all requests as quickly as possible. For complex requests, or requests that require Clinical review, an extension to this time may be required, but the requestor will be informed if a delay is expected.

Urgent requests

If your request is urgent, you must provide a reason for the urgency and the time-frame within which you require the information and all efforts will be made to meet this time-frame.

In some circumstances we may refuse part, or all of a request for health information. We will let you know why. You do have the right of review of such a decision and can do this by contacting the Privacy Commissioner.

If you need any assistance in completing the request form, or have any questions about any of the information above, please email privacyinformationrequests@plunket.org.nz.

Should you be dissatisfied with the information provided to you, a complaint can be raised with the Office of the Privacy Commissioner.