FOR 24/7 EMERGENCY ADVICE: 855-OUCH-OIP (855-682-4647)

Such as injuries, fracture, or other urgent orthopedic problems.
Walk-ins Welcome! No need to request an appointment. Simply visit our Camp Hill or Harrisburg Orthopedic Injury Clinic to be seen. Learn more

ROUTINE APPOINTMENTS: (717) 761-5530

Call OR fill out the following form.

First Name *

M.I.

Last Name, with suffix *

Birth Date *

Date Requested *

Time of Day * AMPM

Physician Requested *

Office Requested *

Please give as much detail as possible about your symptoms. *

Who is your insurance provider?

How can we contact you?

Home Phone Number *

Work/Cell Phone Number *

Email address *

Email transmission cannot be guaranteed to be secure or error-free as information could be intercepted, corrupted, lost, destroyed, arrive late or incomplete, or contain viruses. The receiver therefore does not accept liability for any errors or omissions in the contents of this message, which arise as a result of e-mail transmission.

I accept full responsibility and risk associated with transferring this type of information over the internet

Please mark the box above to accept responsibility and risk associated with transferring this type of information over the internet.

Last Updated on 11/15/2017