Use form below to add a physician profile to the Find-A-Doctor locator. If you require additional assistance, contact:E: info@tricemedical.comP: 949.454.7500 Doctor Finder Profile Form Submitted By Email Phone Physician Information First Name Last Name Select MD DO DPM Specialty Podiatry Non-Op Sports Medicine Orthopedic Surgeon Interventional Radiology Pain Management PM&R Other Facility(s) where procedure is performed (provide Account No. if applicable) Facility Name Facility Account No. Practice Information (Location 1) Location Name Address Address 2 City State Practice Email Practice Information (Location 2) Location Name Address Address 2 City State Practice Email Practice Information (Location 3) Location Name Address Address 2 City State Practice Email Treatment Areas Shoulder Elbow Hip Knee Ankle Foot Diabetic Foot Ulcer SegWay Number of completed cases done using the Tenex Health TX System (for internal use only, must be >10 to be added). Enter Number If less than 10 cases, provide reason for adding Send
