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Please, fill out the form below and one of our Patient Care Coordinators will be in touch with you within 24 hours to book or confirm your consultation.

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Consultation Request with Dads Again

Please, put "Not Applicable" for any required fields that do not apply to you.

Name:*

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Phone:*

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Do you have a specific date and time in mind? Please, let us know and we will do our best to accommodate you:*

Do you prefer an In-Office Consult or Google Meet Consult?*

In-Office Consult (Tucson, AZ)

Google Meet Consult (HIPAA Compliant & Patient Safe)

Days of the week and time frames you are available:*

Are you experiencing Post Vasectomy Pain Syndrome (PVPS) symptoms?*

We ask this because PVPS consults are a necessary and completely different approach from the surgeons point of view in how to provide the best care for you. They also require a longer length of time for the consult to allow for lengthier questions, plus a consult fee. If you are not upfront about having PVPS, your consult fee will not be rolled into your reversal price.

Yes

I am unsure

Communication with the office of International Center for Vasectomy Reversals:

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Do you give us permission to leave you voicemails?*

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Do you give us permission to communicate with you via email?*

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Consult Request with Dads Again

Request a Consultation with Our Experts

Consultation Request with Dads Again

Communication with the office of International Center for Vasectomy Reversals:

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Request a Consultation with Our Experts

Consultation Request with Dads Again

Communication with the office of International Center for Vasectomy Reversals:

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SOCIAL