Order a PVSA Test [Planned Parenthood] Patient Name* First Last Patient Date of Birth* Date of Vasectomy* Date to Send Kit*Kits are usually sent 12 weeks after the date of vasectomy listed above, or you can customize the send date if you'd prefer.Send 12 weeks after Date of Vasectomy aboveSend 14 weeks after Date of Vasectomy aboveI will set the date to send below.Choose a Custom Date to Send Kit Patient Phone Number*Patient Email Shipping Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code We currently serve the United States only. Please email us for info about international orders. Who should we bill?*PPMWVLPPPPNNEPPSATOrdering ProviderOptionalShipping Notes or Special Instructions
