Please fill out the form below & our team will reach out

Referring Provider

First Name

Last Name

Contact Person

First Name

Last Name

Phone

(###)

###

####

Patient Details

Patient Name

First Name

Last Name

Email

Patient Phone

(###)

###

####

Insurance Provider

Area of Concern

Hand

Fingers

Wrist

Elbow

Shoulder

Other

Referred Physician

Please Describe Any Additional Details

Not needing to book an appointment?

Patient Portal

For existing patients, you can connect with your physician and their team regarding prescriptions, follow-ups, and more!

PATIENT PORTAL
Pay Your Bill Online

Need to pay your bill online? Click the button below to be prompted to our secure patient online payment portal. You’ll need your name, DOB, and the amount you owe.

Pay Online
Directions to our Clinic

We are located on the 2nd Floor of The Texas Center for Athletes. Click below for Driving Directions.

Driving Directions