Reversal of Vasectomy or Female sterilisation application form

msword File
فائل کا نام: REVERSAL-OF-VASECTOMY-OR-FEMALE-STERILISATION-APPLICATION-FORM.DOC
فائل کی قسم: DOC
فائل کا سائز: 98 کے بی

Please complete this form for all patients requiring this intervention. If the patient clearly meets the criteria, please submit an application to the RSS team either at bnssg.referral.service@nhs.net or using the e-RS system including all relevant referral documents and await confirmation of funding before making a referral.