Fillable Online Marie Stopes UK Vasectomy Referral Form 2026

1. Click ‘Get Form’ to open the Fillable Online Marie Stopes UK Vasectomy Referral Form in our platform.
2. Begin by filling out the 'Surgery / Practice Making Referral' section. Enter the GP's title, forename, surname, phone number, mobile number, and email address.
3. Next, provide the surgery/practice address details including address lines, town/city, and postcode.
4. In the 'Patient for Referral' section, indicate whether the patient is seeking private treatment or NHS treatment. If it's an NHS referral, include the CCG name.
5. Fill in the patient's personal information: title, forename, surname, contact details (phone and email), address, NHS number, and date of birth.
6. Record the patient's height and weight in the designated fields.
7. The GP must confirm their details by printing their name and signing where indicated. Don't forget to add the GP surgery stamp.

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