Change of participant details form

If you are a participant in the New Zealand Health, Work and Retirement study, you can use this form to update your details if they have changed. You can also use this form to request replacement forms and information sheets be sent out to you.

This page will only be of use to you if you are already, or have been a participant in our Health, Work and Retirement Study.  We welcome any past participants who wish to again be a member of this study.  On this page is a form that you can complete if you have changed, or intend to change in the near future, any contact details for the purposes of this study. All you need to do is fill in the boxes listed below then press the submit button and the information you have given will be sent to our database.

If you have any queries, please contact one of our research officers by phone: 0800 100-134 or email:   hart@massey.ac.nz

Change of details form

Please fill in the form below: 

 

First name:
Last name:

I am a current participant in the Health, Work and Retirement Study.


I have previously been a participant in the Health, Work and Retirement Study in 2006 and 2008, and I would like to rejoin that study.


New contact details
Email address:

Would you prefer updates, newsletters and any other communications to be sent to your email address?


Address:
Address cont:
Suburb:
City:
Post code:
Country:
Home phone number:
Mobile phone number:

Notes (date of change, or any other change/s etc)

Former contact details
Address:
Address cont:
Suburb:
City:
Post code:
Country:
Phone:
Mobile phone number:
Request resources
HART participants can request additional survey resources

I need to request a new:

(Please click on the option/s as required.)





Email Address