Requirements for Obtaining a Vasectomy
A consultation with the Doctor will be required. Also, you will need to write a letter to either Dr. Ronald D. Lee, Dr. Donald M. Norris, Dr. Jeffrey P. Norris, Dr. Narendra Narepalem, Dr. Gordon Gluckman or Dr. Scott Tiplitsky.
In the letter you will need:
- Your name and age
- Your wife's name and age
- The number of children you have
- The reasons for wanting a vasectomy
- You MUST state in the letter that you realize that the vasectomy is irreversible and is not 100% guaranteed and that you realize that there is a possible complication of bleeding into the scrotum and testicular infection.
- Your signature
- Your address and telephone number at home and at your place of business
- The name of your insurance carrier. Please include a copy of both sides of your insurance card.
- Birthdate and social security number
HMO patients will be required to mail referral form with their letter.
Vasectomies are performed in our offices. There is a deposit fee of $100.00 due at time of scheduling. This is non refundable if you do not show up, or call to cancel / reschedule within 48 hours of the scheduled appointment. Our services will be billed directly to your insurance company. After insurance has paid and there is no balance due your $100.00 deposit will be refunded. There will also be a separate charge for pathology from the hospital. If you wish to have your vasectomy done under anesthesia and you are a self-pay patient, you will need to pay the anesthesiologist prior to the procedure.
If you have additional questions about the vasectomy procedure and what is required, call us at 847-823-3185.
