We ask that our patients complete registration online.
There are many advantages to doing the online registration.
Saves time – This is precisely the information that we have always asked each patient to provide on the day of his first visit. By registering online before your first visit, you will not have to fill out a similar form on the day of your consultation and/or vasectomy, unless your vasectomy is performed at a facility other than the doctor’s office, in which case they may require that you complete a few of their forms.
Accuracy of information – By registering in the privacy of your own home or office, you will not be distracted by other activity within our office on the day of your visit. You may also have access to medical information (prior surgeries, medications, names of doctors) that you may not recall on the day of your visit. Plus we can read it … on the handwritten info sheets completed in our office, you’d be surprised how many 4’s look like 9’s and 9’s look like 7’s! This site is secure and your information is kept confidential.
Peace of mind that there will be no surprises on the day of your visit because you are completely informed and prepared. In fact, so much is learned online that a preliminary consultation visit is not required.
Safety – Pre-registration gives your doctor and his or her staff the opportunity to review your history before you arrive and to call you if there are any medical or social concerns, especially important for those patients who choose to have their consultation and procedure on the same day.
Instructions for Online Registration
Read the About Vasectomy Page, including information about what to do before and after your vasectomy.
Watch the Vasectomy Counseling Video
Think about where and when you would like to have your vasectomy. At our Main Office in North Tampa / Lutz, (1) you may have your procedure on almost any Tuesday, Thursday, and many Fridays, and (2) you can usually have the procedure within a few days of your call. At our other locations dates and times are restricted to those in the schedule. Also, at county health department facilities, you must sign a consent form at least 30 days prior to the procedure. Keep in mind that you should recline on the evening of the vasectomy. On the following day, engage in no strenuous activity (no yard work, sports, or lifting over 30 pounds), but you may walk and drive and return to work if your job is not strenuous. Click here to review the schedule.
To schedule, a deposit of $100 (payable by Visa or MasterCard credit/debit card only) is required of all patients except those whose procedures are funded through a county health department or the VA. (If you do not have a credit card account, pre-paid Visa/MasterCards are available at many stores.) The deposit is fully refundable until 7 calendar days prior to the appointed vasectomy date, non-refundable thereafter for either cancellation or postponement. If we receive payment from your insurance company, your deposit will be refunded less deductibles and co-payments. If you have a Health Savings Account credit card, please consider using that for your deposit. Some patients with HSA cards use an alternative card first, then want a refund and the deposit re-charged to the HSA card. If you do this, the refund will be $90, $10 to cover credit card fees.
After registering, please call our office (813-536-1430 or 866-827-8463) to discuss available appointment times and set a date, or we will call you within 2 business days of receiving your registration. If the office is closed when you call, leave a message and we will return the call on the next business day.
Fill in the Registration and Deposit Form and click “Submit”. Fields marked * are Required Fields. The form is secure and confidential. (In fact, your credit card information goes directly to PayPal and we have no access to it when you pay online.) Once we receive your information, 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.
When you are ready to register, click here to register.