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
*required
First Name*
Last Name**
Phone*
Email*
Patient's Date of Birth*
Name of Person Making Request:*
Patient Street Address*
City*
State*
Zip*
Insurance Information
*required
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
*required
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

©2020 Tri-City Orthopaedics. All Rights Reserved.

Official Doctor of the Tri-City Dust Devils

Request Appointment Now!