serving greater Rhode Island Since 1977

Appointment Request

Please use the form below to submit your appointment request and you will be contacted very soon by one of our qualified team members at Lepre Physical Therapy! To schedule by phone, please call 1-800-93-LEPRE (53773)

Name*
First Last
Daytime Phone*
Email*
Office You Wish to Contact
Appointment Information
Primary Care Provider or Referring Physician's Name*
Reason for appointment or Additional Comments:
Time Preference
First Choice*
Second Choice (Optional)*
Time of the Day*

: Hours

Minutes

AM/PM