Refer a patient

Snip Vasectomy Clinics is the largest provider for non-scalpel vasectomy nationwide, with clinics throughout New Zealand.

If you are a healthcare professional and wish to refer a patient please complete the below form.

Patient Referral

Your Name*

Your Email Address*

DHB Association (if relevant)

I am a*:

Medical Council Number*

Name of Practice*

Midwifery Registration Number*

Nurse Registration Number*

Patient Name*

Patient Email Address*

Patient Phone Number*

Patient Date of Birth*

Patient Address

Patient NHI (If Known)

Patient GP name and practice

Reason for referral

Call 0800 Dr Snip to chat to a member of our friendly team. We’re here to help.