Laredo Sports Medicine Clinic

Book An Appointment

All patients require an appointment in order to be seen by a doctor. One of our friendly staff will be happy to help schedule you.

Please use this form for general information purposes only. DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment.

Please complete the following form to request an appointment. We will contact you between 24-48 hours after receiving your inquiry. If you need more immediate assistance please call our office directly Thank you!

Name(Required)

Phone(Required)

DOB(Required)

Preferred Date(Required)

Email(Required)

Preferred Time

Preferred Physician

Nature of Visit

Which body part is injured?

Right

Left

Bilateral

Insurance Provider Name

Insurance Policy Number (Optional)

Do you have a primary care physician?

Yes

If yes, please provide your primary physician’s name:

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Comments

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Book An Appointment

Appointments

Book An Appointment