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Birth Report Form

Have a Question? Drop Us A Line!

If you are considering reversal surgery and have questions about the procedure, fill in the form below and we'll get back to you as soon as we can! If you would like to speak with a nurse for a Free Consultation then feel free to call us at (919) 977-5050.

Please view our most frequently asked questions before sending your questions.

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December Discount*: $1000 Off Quoted Surgery Fee!

Grab Your Phone And Contact Us To Schedule Your Surgery!

Complete Surgery Before December 22nd & Receive $1,000 Off

*$1,000 discount is only available for select December days. Not available to previously scheduled/booked surgeries.

You are welcome to send your medical records to us anytime using the information on our Contact Us page.