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Get Canada Gentle Procedures Clinic Vasectomy Referral 2022-2024

N Name: Phone: Fax: OHIP Billing #: REFERRALS WILL BE RETURNED IF ABOVE INFORMATION IS MISSING IN WHOLE OR IN PART. Consult Consult and Procedure Dear Dr. Sing: Please review the above-named patient for permanent sterilization by way of vasectomy. He is aware of other contraceptive alternatives. He has confirmed that he wishes to have no further biological children of his own. Past Medical History Healthy Other conditions: Medications None Pr.

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