Request an Appointment

Please Complete the Form Below

Note: Any information submitted using this form is transmitted securely and held in strictest confidence, protecting your privacy. Please allow 24 hours for a return call.
If this is urgent please call 509-460-5588 to make an appointment.

Appointment Request

Patient Information
First Name*
Last Name*
Phone*
Email*
Patient's Date of Birth:*
Date Format: MM slash DD slash YYYY
Name of Person Making Request:*
Patient's Address*
Street Address City State ZIP Code
Insurance Information
Do you have insurance?
Do you have insurance?*
- Yes
- No
Is the Policy Holder the same as the Patient?
Is the Policy Holder the same as the Patient?*
- Yes
- No
Policy Holder Name:*
Health Insurance Plan*
Request Appointment
How did you hear about us?*
What is your Preferred Appointment Time?*
Do You Have A Preferred Doctor?*
Urgency*
Reason for Visit*
*
- By checking this box, you acknowledge you are submitting personally identifiable information electronically to TCO for the purpose of providing healthcare. If you prefer to speak with someone please call 509-460-5588 and we can take your information over the phone.
CAPTCHA

CALL US TODAY 509.460.5588

COVID-19 Protocols In Place

Request an Appointment

Please Complete the Form Below

Appointment Request

Patient Information

Insurance Information

Request Appointment

Trust the Tri-Cities' leading orthopaedic clinic

(509) 460-5588

©2018 Tri-City Orthopaedics. All Rights Reserved.

Official Doctor of the Tri-City Dust Devils