Request an Appointment

Thank you for choosing Water & Sports Physical Therapy. We are excited to be your provider of choice. Please select an option below to get started.

New Patient

"*" indicates required fields

Name

First Last

DOB

Phone

Email

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Insurance Name

Insurance ID

Insurance Group Number

What are you coming in for?

If you checked "other", list what you are coming in for below.*

Physician (if applicable)

What specific body part are you having a problem with?

Are you currently in pain? If not, when do you have pain?

How long have you suffered with this problem?

What activities does your pain or problem keep you from doing what you enjoy?

Have you seen someone for this before/what else have you tried?

How did you hear about us?

If "Other" how did you hear about us?

If "Other Insurance", which insurance company?

Preferred Location

List three appointments dates and times you would like to request

By checking this box, I understand that this is an appointment request and is not finalized until a patient care coordinator reaches out to me to confirm.

Current Patient

"*" indicates required fields

Name

First Last

DOB

Phone

Email

What are you coming in for?

If you checked "other", list what you are coming in for below.*

Physician (if applicable)

Preferred Location

List three appointments dates and times you would like to request

By checking this box, I understand that this is an appointment request and is not finalized until a patient care coordinator reaches out to me to confirm.

Request An Appointment

New Patient

Current Patient

CARMEL VALLEY

CARMEL VALLEY (POOL)

CORONADO

CORONADO (POOL)

MISSION BEACH

MISSION BEACH (POOL)

DOWNTOWN

DOWNTOWN (POOL)

SCRIPPS RANCH

Scripps Ranch Pool

POWAY

LA JOLLA

UTC

SDCST