Vasectomy Registration

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

We will call you back to confirm your appointment, if it is not already booked.

Thanks for booking with us.

  • Patient Information

  • DD slash MM slash YYYY
  • (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 our Sydney Vasectomy clinics are now open and strict infection control protocols are being enforced.

A negative COVID PCR test or Rapid Antigen test is required to attend any appointment. A PCR test can be done within 3-4 days of an appointment. A Rapid Antigen test can be done on the same day.

Please wear a mask when visiting our office and kindly scan the COVID Safe App upon entry.

Thank you for your understanding.