My Tubal Was Done On
When would you like to have your procedure?
Immediately (next two weeks)in 30 daysin 60 daysin 90 daysUndecided
pounds or kilograms
Why are you looking to have this procedure
Do you have asthma?
Do you have a history of Hypertension or heart related issues?
How many children do you have via child birth?
How long ago did you get your Tubal Ligation?
What was the technique used for your tubal reversal (if you do not know, leave it blank).
Did you have any C-sections?
If yes, how many
What previous surgeries have you had performed?
Do you take any medications? Which ones?
Do you have any medical conditions that we should be aware of?
Have you ever had a problem with Anesthesia?
Are you willing to take time off work to recover from this surgery?
Do you have your Tubal Ligation report ( Upload here )