Existing Patient Appointment Request

Items with a * are required.

Please Note:

  • This is a request for an appointment. You cannot schedule your own visit.
  • I may not be available on your requested day or time, but will do my best to accommodate your request.
  • I will not be able to accommodate same day appointments.
  • I primarily only see patients on Wednesdays. Please choose a date and window of time that you are available.
  • A requested time is not a guarantee for an appointment. I will do my best to accommodate, and will contact you to confirm an appointment time if available.
  • Please do not text or call to alert me that you have requested an appointment.
  • NOTE: Please choose only Wednesday appointments.
    MM slash DD slash YYYY
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  • If you have availability at different times of the day, please do not complete multiple request forms. Please input the overall beginning and end times. In the field below, please input the different times you are available (for example “11:00am–1:00pm" and “4:00pm–5:00pm”
  • I understand this is a REQUEST for an appointment and Dr. Sood will contact me to confirm the actual time.