Ready to make your appointment?#

Once you have reviewed the information on the All About Vasectomy page and your decision is made, it is time to complete the application.

Explanatory video#

You must watch this entire explanatory video before submitting the file opening form.

File opening form#

In order to perform the no-scalpel vasectomy at our clinic, you will first need to go through certain steps.

First, you will need to watch the how-to video.

It contains all the information necessary to make an informed decision on whether or not to proceed with the surgery. It is also recommended that you write down your questions on a piece of paper as the video scrolls. If at the end of it, some of your questions have not been answered, Dr. Boucher will be happy to answer them during your first consultation.

Then you need to complete the first section of the PDF form (up to the signature requested on the first page).

To do this:

  1. Download the following PDF file: vasectomy form;
  2. Open it in your PDF software;
  3. If you do not have PDF software, we suggest you download "Adobe Acrobat Reader DC" by clicking on the following link: get.adobe.com/reader/
  4. Fill out the form using the interactive fields without forgetting to check the signature box;
  5. Finally, send it to us by email at info@vasectomie-pierre-boucher.ca including your doctor's prescription copy if you have one.
  6. The form must be completed by the patient who will have the surgery, not their spouse. Once done, the form will be sent to us and a consultation will be given to you within 10 working days with Dr. Boucher.

*Note that the $30 vasectomy cancellation fee shown in the video has been changed to $60.