Consultation Questionnaire
You need to complete this questionnaire to initiate contact with us.
Once we receive the questionnaire with all details, we will provide you with a free personalised report and the opportunity to have further Remote video or face-to-face consultations which are chargeable. Click Here for the details.
Therefore please take care to provide answers to all questions. We will require additional full details in the following situations.
- Previously failed Vasectomy reversals ( When, where, what was the outcome, any difficulties?)
- For previous IVF (How many cycles, details of partner's fertility, the reason for the failure if known)
- Previous intake of Testosterone or Bodybuilding steroids ( when, duration, any change in the size and texture of the testicles)
- Please provide full details for any other medical problems, taking blood-thinning medicines.
(The expansions of abbreviations used in the following questionnaire: DOB - Date of Birth, DM- Diabetes, IHD- Ischaemic Heart Disease such as Angina or Heart attack, HT- High blood pressure)
Click here to complete our detailed questionnaire.
Make sure your email address and mobile number are correct. You will receive the report in your email within two working days, and a text will be sent with the info on the password for the document.
