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Application Form (All fields are required)

1. Residency:
Are you currently legally entitled to work in New Zealand?

2. Residency:
Please indicate your current residency status

3. Advertising Avenue:
Where did you hear about this position?

4. Current / Previous Employee:
Are you currently or have you previously been employed by Healthscope NZ Ltd or any of its subsidiary companies?

5. Current / Previous Employee:
If yes please detail where, what position and dates. If you answered no to question 1, simply write NA here.

6. Qualification:
Do you have QMLT / QPT (Phlebotomy) or similar?

7. Qualification:
If you don't have one of the above qualifications, do you have the following?

8. Registration:
Are you registered with the Medical Sciences Council of NZ

9. Registration:
Do you have a current APC?

10. Skills and Experience:
Do you have previous experience working in a Medical Laboratory, Medical Centre, or Healthcare industry?

11. Drivers Licence?:
Do you hold a current full NZ Drivers Licence?

12. Employment:
Would this position be your sole employment?

13. Holidays:
Do you have any time off or holidays planned over the next 6 months?

14. Availability:
How soon would you be available to commence employment?

15. Hours of Work:
Are you available to work additional hours if required?

16. Handling Specimens:
Are you open to handling contained specimens, i.e. human blood, faeces, urine, tissue etc?

17. Health:
Do you have any health related issues or are you on any regular medication which may impact on your ability to perform the tasks of the position you are applying for? Please provide brief details.

18. Health:
Are you allergic to or do you have any sensitivty to any substances or chemicals? If yes, please detail

19. Criminal Convictions:
Do you have any present criminal convictions, not including any concealed under the Clean Slate Act?

20. Criminal Convictions:
Are you awaiting the hearing of charges in a civil or criminal court of law?


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