Loddie F. Roeder, Jr., M.D.

Microsurgical Vasectomy Reversal: (830) 237-5282

LODDIE F. ROEDER, JR., M.D.
TEXAS VASECTOMY REVERSAL CENTER
 
VASECTOMY REVERSAL FORMS
 
 
Please fill out the following three forms and send via:
 
Fax:  830-629-0224
 
 
 Or Mail:  Loddie F. Roeder, Jr., MD, 189 E. Austin St., Ste. 101
                             New Braunfels, Texas  78130
FORM 1  PATIENT INFORMATION SHEET
FORM 2 NOTICE AND ACKNOWLEDGEMENT OF PRIVACY PRACTICES
FORM 3 INFORMED CONSENT