Get Post Vasectomy Request Form - Hampshirehospitals.nhs.uk

This guide provides clear and supportive instructions on completing the Post Vasectomy Request Form online. By following these steps, users can ensure that their submission is accurate and complete, facilitating effective processing.

Follow the steps to fill out the form correctly.

1. Click the ‘Get Form’ button to access the form and open it for editing.
2. Begin by entering your NHS number and laboratory number in the designated fields. If available, attach your label with your details to the form.
3. Provide your surname and forename in the appropriate sections. Be sure to include your date of birth and address.
4. Indicate the date of your vasectomy procedure. Ensure you leave the 'Lab use only' fields blank; this is for laboratory personnel only.
5. Specify the date and time of sample production. Check the box to confirm if the sample was produced on-site at the fertility lab.
6. Indicate days since the last ejaculation and confirm if you collected the entire sample in the container. Answer with ‘Yes’ or ‘No’.
7. Select the correct box for the sample number: 1st, 2nd, or another option.
8. Sign and date the form to confirm that all details are correct and that your sample can be used for quality control.
9. Review the patient checklist to ensure you have adhered to all instructions regarding appointment booking and sample collection.
10. Finalize the form by saving your changes. You may print or share the completed document as necessary.

Submit your completed form online today to ensure timely processing of your request.