Single Visit Vasectomy Registration Form

After you submit this form you will be redirected to a page that will allow you to select an appointment date and time and pay the scheduling deposit.

If you are trying to schedule either a 1) consultation visit or 2) sedation vasectomy then DO NOT COMPLETE THIS FORM! You will need to call and speak to a staff person before you can schedule. The staff will email you separate instructions to schedule either of those two visits.

If you would like a single visit vasectomy procedure (everything done at one visit)…then this is the correct form.