Vasectomy Registration Instructions

1. Please read the Vasectomy Information Page in this website. Review our Fees and Payment Options and Instructions for Before and After Vasectomy.
2. Please view our counseling video before registering.
3. Think about where and when you would like to have your vasectomy. See our schedule. Also, if you are being referred by a county health department that is paying for your vasectomy, you must sign a consent form at least 30 days prior to the procedure.
4. Fill in the following Registration and click "Submit". Fields marked * are Required Fields. The registration form is secure and confidential. Once we print the completed form, we have your pertinent medical history and no need to have you fill out more forms. You will see the printout and have an opportunity to make changes on the day of your visit. After registering, please call our office between 9 AM and 4 PM, M-F, (813-536-1430) to secure an appointment date and time. You will then receive confirmation by email.