The SWISH Hip Service is comprised of fellowship trained physicians who specialize in hip disorders in patients of all ages. Not all hip pain is the same. In an effort to get you to the most appropriate specialist and resolve your symptoms most efficiently, please complete the online appointment request below. Please include a brief history as it relates to your hip problem. Our team of physicians review these requests on a daily basis and will respond to you quickly with options for an expedited office visit. We also provide a complimentary review of your radiographs. For more information regarding the radiograph review, please click on the appropriate link.

To request an appointment, please enter the information and press the "Send Appointment Request" button when you are through.

(*) Your name and phone number or email are required fields, so that we can contact you to confirm your appointment

Your Personal Details
 
First Name * Middle Initial Last Name *
 
Age * Sex  
Male Female
Injury Details *
  Description of Injuries need location of injury and side (right or left)

Recent Imaging
  Xray MRI CT Scan Others
Pain Scale

Using the diagram below, click on the crayon which best represents your pain and hold your mouse button to draw on the affected area of the body.

 

 



 

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Contact Details
 
Home * Mobile Number
   
Business Email Address *
   
Preferred Contact Method:
Email Phone
Preferred Physician
 
Patients Insurance Information *