International Patient Form

International Patient Information Form

international patients are welcome to have their no scalpel vasectomy at TVVSThe form below will help any international patient coming from abroad to focus his mind and also ask the questions himself about some of the pitfalls of vasectomy. However, please read this before you fill in the form. Once you are clear in your mind on how to overcome the difficulties, the rest should be very easy.

Security Alert!

Websites are considered safe where the encrypted lock is displayed in the browser. Please ensure you are aware of the facts below before submitting a form.


  • Any information transferred via email or webform is not totally secure. TVVS lets you use email if you indemnify it for any unintended diversion of information.
  • Your personal information could be intercepted by other family members or friends who have access to your email account
  • If you are using a work email account, your employer may have access to these emails and they may be stored and backed up on their system
  • Your personal information will be open to access by cyber products that have the ability to intercept emails without authority
  • TVVS cannot be held responsible for the security of your personal information coming into and going out of our network in this case
  • There is no guarantee that the information sent has not been changed before receipt
  • The confidential email(s) sent could be forwarded to other members of the public
  • Your personal information cannot be encrypted or sent in a locked file format
  • You will not be informed of the exact date the information is sent. It is your responsibility to retrieve the information

TVVS assurance:

  • A review of the information requested will be carried out and the organisation reserves the right to refuse to email information if deemed inappropriate or sensitive
  • A copy of any information sent will be retained in the organisations file (NOT in your medical records unless you specifically request this) and the origin of the information will be verifiable