Thank you for visiting Urology of Indiana. To schedule a Vasectomy appointment, please complete the following form. All fields must be completed. A member of our staff will be contacting you.

Please enable JavaScript in your browser to complete this form.

Name *

Email *

Daytime Phone *

Location Preference *

• No Preference
• Avon
• Bloomington
• Carmel
• Fishers
• MedTech Park
• Greenwood
• Greenfield
• Naab Road
• Post Road

Day of the Week Preference *

• No Preference
• Monday
• Tuesday
• Wednesday
• Thursday
• Friday

Time Preference *8:00am8:30am9:00am9:30am10:00am10:30am11:00am11:30am12:00pm12:30pm1:00pm1:30pm2:00pm2:30pm3:00pm3:30pm4:00pm4:30pm

Submit