Below are the Guidance and Agreement Request Forms for District Health Board (DHB) and the Ministry of Health teams to prepare and submit agreement requests to Sector Operations at the Ministry of Health.

Working with Agreements

A guide for contract managers and administrators in planning, setting up, and managing their agreements.

Working with Agreements guide

Agreement Request Forms

Video on how to complete the Agreement Request Form: https://www.youtube.com/watch?v=EKdcrcYsDrA

Forms to be completed when requesting a new agreement, or variation of an existing agreement.

For DHB use

• Agreement Request Form - Word document (for DHB use)

• Agreement Request Form - Excel file (for DHB use)

• Guide: Agreement Request Process Guide (for DHB use)

For Ministry of Health use

• Agreement Request Form - Word document (for Ministry of Health use)

• Agreement Request Form - Excel file (for Ministry of Health use)

• Guide: Agreement Request Process Guide (for Ministry of Health use)

Assignment Request Form

To be completed when requesting assignment of an agreement.

Assignment Request Form (for DHB use)

Assignment Request Form (for Ministry of Health use)

Novation Request Form

To be completed when requesting novation of an agreement.

Novation Request Form (for DHB use)

Novation Request Form (for Ministry of Health use)

Pharmacy Request Form

To be completed when requesting a new Pharmacy agreement, or variation of an existing Pharmacy agreement.

Pharmacy Request Form

Addition and Amendment (PERORG) Form

To be completed when requesting the creation of a new provider or amendments to an existing provider in the Ministry of Health Contract Database (‘PERORG)

PERORG Form