Forms

KoruHealth Forms

Current Air New Zealand Employees

Application Form
If you want your partner or dependant(s) to be included in your membership, you’ll need to send copies of a marriage and/or birth certificate(s)* along with your application form
KoruHealth CLAIM FORM v.2 April 2019

KoruHealth CHANGE FORM v.2 April 2019
KoruHealth 19+ Application Form v.2 April 2019
If a member’s child aged 19 or older wishes to have their own single membership, they can fill out and submit this form. The member retains responsibility for payment of the adult child’s fees.

Past Air New Zealand Employees / Retirees


KoruHealth CLAIM FORM v.2 April 2019
KoruHealth CHANGE FORM v.2 April 2019
KoruHealth 19+ Application Form v.2 April 2019
When a member’s child reaches 19, if they wish to have their own single membership, they can fill out and submit this form. The adult child must be covered under the membership at the time they apply and the member retains responsibility for payment of their fees.