Online Vasectomy Registration

Advantages

1. 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 Planned Parenthood (PP) facility, in which case PP requires that you complete a few of their forms.
2. 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.
3. 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.
4. Safety - Pre-registration gives Dr. Stein and his 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

1. Please read the Vasectomy Information Page in this website. This page contains helpful financial information and instructions for before and after vasectomy.
2. It may be information overload, but we will also ask you to view our counseling video before your procedure. It is available here online as a small streaming video and at our Tampa office and outfield locations as the full screen DVD version.
3. Think about where and when you would like to have your vasectomy. At the Tampa office, (1) you can have your procedure on almost any Tuesday, Thursday, or Friday afternoon, 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 and engage in no strenuous activity the next day (no yard work, sports, or lifting over 20 pounds). On the following day, you may walk and drive and return to work if your job is not strenuous.
4. 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. (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.
5. Fill in the Registration and Deposit Form and click "Submit". Fields marked * are Required Fields. The information comes to our database as though we entered it ourselves from information provided by you in writing (as office forms) or by phone. It is secure and confidential. (In fact, your credit card information goes directly to Merchant Services and we have no access to it when you pay online.)Once we print it, 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.
6. After registering, please call our office (813-972-1365, 813-903-1902 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.

Please wait while you are forwarded to our registration page.