Call us to Book : 0490 813 714 | Vasectomy Clinic in Sydney, NSW | Contact

Vasectomy Registration

Vasectomy Registration 2018-06-19T10:04:40-04:00

Please complete the registration form below for no-scalpel vasectomy.

We will call you back to confirm your appointment and answer your questions.

Thanks for booking with us.

  • Patient Information

  • Date Format: DD slash MM slash YYYY
  • (if available)
  • (if available)
  • Referring Doctor (if applicable)

  • Family Information

  • Enter “none” if none.
  • Enter “none” if none.
  • Enter “none” if none.
  • Enter “none” if none.
  • Contraception

  • Medical History

  • Surgical History

  • Medications

  • Enter "none" if none.
  • Allergies

  • Enter “none” if none.
  • Vasectomy Agreement

    You must consent to the following:
  • This field is for validation purposes and should be left unchanged.

All Gentle Procedures clinics are open and running as usual until further notice.

Any patient who has traveled overseas in the last 14 days, been exposed to a case of COVID-19 or has symptoms of cough, sore throat, breathing problems or fever, please inform the clinic by phone before confirming an appointment.

Please read our COVID-19 Information Page.

Thank you.