Suite 207, 1015 Regent Street, Fredericton, NB E3B 6H5
Fredericton Urology Clinic
HOME
OUR TEAM
OUR EXPERTISE
UROLOGIC ONCOLOGY
GENERAL UROLOGY
VASECTOMY/VASECTOMY REVERSAL
CONTACT
PROSTATE CANCER SCREENING
VASECTOMY SELF REFERRAL
VASECTOMY REVERSAL
PATIENT EDUCATION
More
Use tab to navigate through the menu items.
Vasectomy Reversal Self Referral
Full Name
Medicare Number
Street Address
City
Phone
Postal / Zip code
Birthday
Email
Family Doctor
Provide any information you would like us to know.
SUBMIT
By completing this form, you acknowledge that the confidentiality of electronic communication cannot be guaranteed
. If you have concerns about confidentiality and prefer to provide information by phone, please call 506-457-4783.