Name on the Card* Job Title* Service* Location where position is basedSelect valueWhangarei HospitalDargaville HospitalBay of Islands HospitalKaitaia HospitalTohora House Employment type*New Employee Current Employee (Replacement Card)VolunteerContractor Position TypeSelect valuePermanent Position (Fulltime or Parttime)Fixed Term or Contract positionVolunteer Contract Expiary Date (If Fixed Term or Contract )Access Requirements General AccessNone (Photo ID Only)Whangarei HospitalDargaville HospitalBay of Islands HospitalKaitaia HospitalBreast ClinicTohora HouseManaia HousePuriri HouseOther Restricted AccessWard 1 Med RoomWard 2 Med RoomWard 3 Med RoomWard 4 Med RoomWard 14 Med RoomWard 15 Med RoomWard 16 Med RoomBOI Med RoomKTA Med RoomDRG Med RoomBreast Clinic Med RoomED Med RoomOther Any other notesPlease Note: If you request access to an area not designated to authorise to, your request will be checked with the appropriate manager before it is actioned. Authorised By* Cost CodeSubmitReset