how to get started arranging your tubal reversal surgery

getting started/checklist/formsbaby

If at any point in the process of “getting started” you need some assistance you may call the office and speak to any of our knowledgeable staff members. The receptionist will be the person to organize and retain your records until all needed documentation has been received. Once all documentation is in place, Jody Halloran will be the contact person to coordinate for Dr. Williams, Dr. Bateman or Dr. Smith to review your records.

Our office can be contacted from 8:00 a.m. EST to 5:00 p.m. EST at 1-866-540-5190, or 434-654-8520 or by e-mail.  Our fax number is 434-654-8521. Mailing address: 595 Martha Jefferson Drive, Suite 390, Charlottesville, VA 22911.

Checklist- Steps you need to take to move forward

Not everyone is a good candidate for outpatient tubal ligation reversal.

In most cases we need your BMI to be below the “obese” range- which is less than 30. Please use the BMI calculator link to put in your height and weight to determine your BMI. If your BMI is above 30 you usually need to lose weight before you are a candidate for our minilaparotomy outpatient surgery approach for tubal ligation reversal. There are circumstances where a woman distributes her fat mostly in hips, thighs or chest and not in the belly. If you have a BMI above 30 but don’t have a significant fat in your belly we’ll ask you email us a picture in a bathing suit or bra and underwear from front and side so we can get a better idea if you are a candidate prior to weight loss.

You can calculate your BMI using this BMI calculator.

Complete the following steps to get started:

Step 1- filling out a questionnaire to help us to get to know you. The questionnaire gives us details of your medical history, past surgeries, weight and height and other important details.

In general, outpatient tubal reversal is possible in women less than 200lbs. However, there is significant variation depending on your height and where fat is distributed. An inpatient tubal ligation reversal is also an option, but more expensive. We can let you know the details of that if you are not a good candidate for outpatient “same day” surgery.  If you are over 200lbs. and you do not have a significant amount of fat distributed in your belly, then e-mail a photo in a bikini or underwear and bra to Jody Halloran.

Step 2- Obtain the operative report and pathology report from the doctor who did the procedure or by calling the hospital where it was performed.

They usually require you to complete a medical record release form in order to obtain a copy.  If a copy of your operative report is not able to be found then, oftentimes, it is still possible to give you good advice about your chances of success. Many women remember their doctor telling them how their tubes were tied. For instance, many women know that clips were applied. We are happy to help you with obtaining the operative report but you will still need to fill out a medical record release form and provide us with a copy.  Download the medical release form.

Step 3- Complete a female medical release form and a male medical release form. These are not medical releases to obtain medical information on either of you but to allow us to talk to both of you about each other’s care, results and treatment.  Please print two forms: one for you to complete with your partner’s information and one for your partner to complete with your information.  Also complete the new patient registration form.

Step 4- Fax, e-mail or mail the questionnaire, registration form, male and female medical releases, and operative report and pathology report to Jody Halloran.   Fax: 434-654-8521; e-mail Jody.Halloran@rmscva.com; address 595 Martha Jefferson Drive, Suite 390, Charlottesville, VA, 22911

Step 5- Call the receptionist to acknowledge receipt.  The review process will take about a week and one of the staff members will contact you to set up a time for Dr. Williams, Bateman or Smith to consult with you by phone if you live outside the region or an appointment here in the office.

Step 6- We always suggest a semen analysis be done prior to surgery.  This can be done locally and we can order it for you.

Initial Evaluation by Phone

We want to make it as easy as possible for you to access us no matter where you live.  You will need a physical exam and to complete the surgical paperwork with Dr. Williams, Bateman or Smith prior to your surgery. So, if you live in the region it is most efficient to have the initial visit and physical exam done here in advance. If you live more than two hours away, we are happy to contact you to find out more information and to complete much of the screening by phone.  When your surgery is scheduled, an appointment for physical exam and consenting will occur the afternoon prior to surgery the following day or the day of surgery.

Patient Forms

Click to download any of these patient forms. Some of these forms must be completed by the male and female.

Los Formularios de Inscripción Españolas

E-statement Information You can now receive your bills from RMSCVA electronically. 
Sign up for electronic statements here: Electronic Statements  Instructions for accessing your electronic statement: 
enter CodeID:  REPMSC01  
Access#: 2355206-1-1

Jody Halloran is the Tubal Reversal Coordinator. Her contact information is as follows:
Toll free: 866-540-5190 or local: 434-654-8520 : Fax 434-654-8521 Mailing and physical address: 595 Martha Jefferson Drive, Suite 390, Charlottesville, VA 22911
E-mail address jody.halloran@rmscva.com