For Physicians: This referral pathway connects your patient with independently licensed surgeons affiliated with Town Surgery NY PLLC. Submission of this form does not establish a physician-patient relationship. Clinical care is provided under a separate engagement between the patient and the affiliated surgeon.

Referral Criteria

Cases We Accept

We welcome referrals across the full spectrum of hernia complexity — from straightforward primary repairs to the most technically demanding reconstructions.

Recurrent Hernia

Failed prior repair(s), any approach

Mesh Complication

Infection, migration, chronic pain, fistula

Loss of Domain

Giant ventral / incisional hernia

Enterocutaneous Fistula

From prior failed repair or mesh

"Inoperable" Patient

Told too high-risk elsewhere

Primary Hernia

Inguinal, umbilical, incisional, femoral

Why Physicians Choose Us

A Referral Program Built for Clinicians

We understand that referring a complex case is a reflection of your judgment. We take that seriously.

24–48 Hour Triage

Every referral is reviewed by a surgeon within 24–48 hours. You receive a direct response — not a call center.

Multidisciplinary Team

General surgery + reconstructive plastic surgery working together. Most programs offer one; we offer both.

Imaging Review Included

Upload CT or MRI directly. Our team reviews preoperatively so your patient arrives with a plan already in motion.

Closed-Loop Communication

You receive a written summary of the evaluation and surgical plan. Your patient stays your patient.

30+ Hospital Locations

Privileges across the NY metro area and NJ — we can often operate near your patient's home.

Complex Case Expertise

TAR, component separation, robotic-assisted reconstruction, hybrid open-laparoscopic — all available.

Submit Referral

Complete the form below or call directly

Surgeon Review

Case reviewed within 24–48 hours

Patient Contact

Your patient is contacted to schedule evaluation

Closed-Loop Report

You receive a written summary of findings & plan

Referral Submission

Submit a Clinical Referral

Complete the form to initiate a referral. A surgeon will review the case within 24–48 hours and your patient will be contacted directly to schedule an evaluation.

Upload imaging directly

Secure CT/MRI upload

Secure & Confidential

All referral information is transmitted securely. Patient data is handled in accordance with HIPAA guidelines. Imaging uploads use encrypted transfer.

Urgency Level *

Referring Physician Information

Physician Name *

Specialty

Practice / Institution

Callback Number *

Physician Email *

Patient Information

Patient Name *

Patient Date of Birth

Patient Phone *

State of Residence

Clinical Details

Case Type *

Number of Prior Repairs

Mesh Present?

Imaging Available?

Clinical Summary / Reason for Referral *

Max 500 characters0/500

I confirm that I am a licensed healthcare provider submitting this referral on behalf of my patient. I understand that submission of this form does not establish a physician-patient relationship between the patient and any affiliated surgeon. Clinical care, if pursued, will be provided by independently licensed physicians affiliated with Town Surgery NY PLLC under a separate engagement. I have obtained appropriate patient authorization to share this information.

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A Trusted Destination for Your Most Difficult Hernia Cases