Call us today on 0800 472 469 or simply fill out the quick and easy booking form below.
Full Name *
Passport Number *
Frequent Flyer Number: (e.g.Airpoints number)
I understand that the payment of NZ$450 is for the booking confirmation and is non refundable *
I understand that I pay the cost of my procedure to the Hospital after my initial consultation with my surgeon. *
Preferred Payment Method
I elect to pay my booking confirmation of NZ$450 by *
Credit card ( we will call you )
Internet transfer ( we will email you our account number)
Person(s) Accompanying You:
(Name as in Passport)
First Name 1
Last Name 1
First Name 2
Last Name 2
First Name 3
Last Name 3
Please read the disclaimer carefully because it is an essential contractual condition of all bookings accepted by Beautiful Escapes.
I have read, acknowledged and fully understand the attached disclaimer and accept it. *
On receipt of this Booking, Beautiful Escapes will respond with hospital registration and other necessary documents.
Please enter the verification code in the image above *