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Apply to join the Southern Clinical Network

This is the official application form for general practices wishing to join the Southern Clinical Network (SCN). The following terms and conditions apply:

  1. At this time, applications for membership are invited from General Practices located in Otago and Southland or from General Practices outside Otago or Southland that are owned wholly/partly by South Link Health Services Ltd (SLHSL).
  2. Qualifying General Practices may submit an application form at any time from 2 November 2014 onwards.
  3. Applications from General Practices must be submitted and signed by one of more people who are authorised to act on behalf of the owners of the General Practice.
  4. There is no fee for joining SCN and no ongoing membership fee to become a member of SCN.
  5. Applications will be reviewed and responded to in writing within 10 working days of receipt at SCN.
  6. The services offered by SCN will only be available to General Practices that have been accepted in writing as members of SCN.
  7. The services will be available from 1 February 2015 onwards. Not all services may be available immediately.
  8. Your General Practice is asked (on this application form) to indicate which of the services on offer you wish to receive. This is an indication and will not be binding on your General Practice but is required to enable SCN to plan for the rollout of the various services.
  9. The General Practice may terminate its membership of SCN by giving written notice of twenty working days to SCN, at which time all access to the services on offer from SCN will cease.
  10. SCN may terminate its provision of one of more of the services listed in this application form by giving twenty working days notice to the General Practice.
  11. To ensure that SCN has a strong position in negotiating service contracts on behalf of SCN General Practices, the General Practice listed below, mandates to SCN to negotiate on its behalf, the terms of service agreements with health service funders including the Southern PHO, Southern DHB and ACC. This mandate to negotiate service contracts is given on the condition that SCN will consult with the General Practice during the service contract negotiation process and that the General Practice will have the right to decide whether or not to accept the negotiation position that SCN may propose.

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Practice Details - Name and address of the General Practice requesting membership:

Name, contact details and acceptance of terms of the owner or owner representative of the General Practice requesting membership:

Please indicate which of these services your practice would be interested in.

There is no cost to the general practice unless indicated.

50% subsidy by SCN

Best price IT hardware and software and discounted installation costs

By negotiation with SLHSL

Cost of equity shares

As the owner(s) representative named above, I/we have read, understood and accept these terms and conditions of membership of the Southern Clinical Network and hereby apply for membership of the Southern Clinical Network on behalf of the General Practice identified above.