Surgeon Submission: Excision Surgeon Directory Vetting Form

Thank you for your interest in being listed in the Endo Excision for All Excision Surgeon Directory. Our goal is to help patients locate surgeons who provide evidence-based, patient-centered endometriosis care, with a clear emphasis on excision surgery.

To safeguard patient trust and ensure accuracy, all listings require completion of this submission form and a vetting review. Submitting this form does not guarantee inclusion, and we may request follow-up information or clarification.

Who This Form Is For

This form is intended for surgeons who:

• Perform endometriosis excision as part of their current surgical practice

• Can describe their training, experience, and surgical approach transparently

• Support informed consent, respectful care, and appropriate referrals when indicated

• Are willing to attest that all information provided reflects their current practice

Our review process is designed to ensure directory information is complete, accurate, and helpful to patients making medical decisions. We may review:

• Consistency of responses within the form

• Alignment between stated services and publicly available practice information (e.g., website descriptions)

• Clarity around excision practice, referral patterns, and documentation standards

• Commitment to transparency and patient access to information

If additional context is needed, we may contact you using the email provided.