What to bring to office consultation visit
Prior to your date of surgery, please provide us with as much information as possible. Dr. Towfigh will be reviewing these prior to your visit. This will make your consultation time in the office much more efficient, maximizing your one-on-one time with your surgeon.
Please print and complete the forms below prior to your visit:
- Hernia Health Questionnaire
- Health Insurance Assignment of Benefits
- Hernia Database Consent Form
- Photography Consent Form
- Americas Hernia Society Quality Collaborative, Information for Patients
If you have had any of the following performed in the past 10 years, please provide documentation to our office:
- Any operation related to development of your hernia or pain complaint (this may or may not be a hernia operation)
- You can get a copy of your “Operative Report” from the hospital or center where you had the procedure or from your surgeon’s office.
Radiologic Studies (Ultrasounds, CT scans, MRI scans)
- Any radiologic studies of the area of your hernia or pain complaint
- You must also provide the CD of the radiologic images. Dr. Towfigh reviews the images herself, and does not rely solely on the radiologic report.
- Any narrative you wish to provide about your symptoms, journey, etc.
Sending Your Reports
Please mail CDs of radiologic/imaging studies to our office, and use fax or email for other documents.