Make a Referral

GP’s / health professionals

Please complete the following form if you would like to refer a patient. If you prefer, you are welcome to email a referral letter directly to info@vbclinic.co.nz

Clients

You do not need a referral to attend Vertigo Balance Clinic. Please contact us if you have any queries, or if you would like to make an appointment, click on the button below.

Make an Appointment

Patient details:

First Name

Last Name

Patient contact number(s)

Patient email

Reason for referral

Referrer's name

First Name

Last Name

Referrer's contact details

Make a Referral

GP’s / health professionals

Clients

Location

Contact