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Bernard Rosenfeld MD - Online Registration

Dr. Rosenfeld and the nursing staff will review your information to determine if you are a candidate for Tubal Reversal surgery. Once it is determined that you are a candidate for the tubal reversal surgery, our staff will arrange your appointments. If you require any assistance in getting started, please call our office at 713-790-0099 and we’d be very happy to assist you.

Full Name*

First NameLast Name

Address*

Street Address

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Date of Birth*

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Name of hospital where your Tubal Ligation surgery was performed:*

City where hospital is located

Year your ligation surgery was performed

Last Name at that time