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Tubal Reversal Scheduling Questionnaire

Tubal Surgery
Scheduling Questionnaire

The Tubal Surgery Scheduling Questionnaire can be found at the bottom of this page.

If you are having problems competing this form on-line we can email this form to you or you can by-pass this completely and schedule by phone directly with the nurse.

By completing this surgery scheduling questionnaire your health interview and surgery scheduling with the reversal nurse will be more efficient.

Instructions On Completing The Questionnaire

  1. Submit this Reversal Surgery Scheduling Questionnaire before paying your scheduling fee.
  2. Provide the contact information for your nearest lab so the scheduling nurse may fax a lab order for any required lab testing. You can use any local lab but we encourage you to consider LabCorp. Their website (www.LabCorp.com) will help you find the lab nearest you. The nurse will need the name of the lab and the phone and fax numbers for the lab.
  3. We recommend you follow-up with your local physician within 4 weeks of surgery.
    Only provide the contact information of the doctor you will see after surgery.
  4. If you do not have all of the information requested in this questionnaire you are welcome to skip those sections. You can provide the required information to the nurse at the time of your phone scheduling.
  5. Please call at any time if you have questions.
  6. After you submit this form and pay your scheduling fee, a Scheduling nurse will call you within 1 to 2 business days to schedule your surgery. Surgery scheduling does not occur on weekends or after 5 pm East Coast time.
  7. A nurse will only call you after your questionnaire has been submitted, you have paid the scheduling fee, and we receive email confirmation your scheduling fee has been paid.
  8. Available surgery dates change frequently. Your surgery date can only be confirmed after you have completed the phone scheduling and your full surgery payment has been received.
  9. If you are financing any portion of the surgery you will need to know the amount of financing you qualify for before you start the scheduling process.

Get Started With Surgery Scheduling


Have Questions? Leave a comment here or visit our contact page.

19 Comments

Hortencia Hernández Reply

Necesito hacerme la cirugía para volver a tener bebé


    Dr. Monteith Reply

    Hortencia
    Call us at (919)977-5050. Ask to speak with Oyuki or Karla. They speak Spanish and can help you.


Laura knoll Reply

My records was destroyed can I still. Have the surgery I had the clamps put. On when I was 21


    Dr. Monteith Reply

    Clamps are excellent for reversing and the chance of pregnancy could be as high as 80%. We do not need your records because we can reverse most tubal ligation procedures.


Latoya Ellis/peake Reply

Yes i would love to no if i call set everything up them i would not be ready to pay the 150 until next week some time .or two give and take and i nd to no if there is a payment pay i can not pay all at once if so please let me no thank you.oh my paperwork is allready there so i just nd to no how to start the pay or to visit


Nicole Reply

Whats the current scheduling time frame? Is there a waitlist?


    Dr. Monteith Reply

    We are currently scheduling out to middle or end of October. Most patients can get a surgery date within 3 to 6 weeks of calling and scheduling.


MYRIAM Reply

ME GUSTARIA SABER SI NESECITO LOS LABORATORIOS ANTES DE LA PROCEDURE PARA CHEQUIAR QUE ES LA CIRUJIA QUE NESECITO YA QUE MI OPERACION PARA NO TENER BABIES FUE EN 08/2007 NO SE SI FUERON BURN O CORTADOS LA CITA ME GUSTARIA PARA MEDIADOS DE OCTUBRE. MUCHAS GRACIAS Y BENDICIONES (TAMPA, FLORIDA)


    Dr. Monteith Reply

    Call us tomorrow and ask to speak with Oyuki or Karla. They speak Spanish and can help answer your questions.

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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