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Complete the correct intake form so Dr. El Djouzi can prepare for your consultation. It ONLY takes about 15 minutes.

Hernia Surgery Consultation

If you are seeking a hernia consultation, choose this pathway to share your medical history and current complaints.

General Surgery Consultation

Select this option if you’re seeking a general surgery consultation so we can review your medical history and complaints.

Start Your Form

Important: Please submit your intake form within 24 hours of booking to keep your spot.

Please be on time to avoid delays or disruptions to the clinic schedule.

Your appointment is confirmed. A confirmation email has been sent with your Zoom link (if you opted for a virtual meeting) or our office address (if you opted for an in-person visit) and the option to add it to your calendar.

Questions? Call or text our team at 773-365-1300.