Craig S. Rock, M.D., F.A.C.S.

713.799.8330

Plastic Surgery

Appointment Request Form

Please use the following form to request an appointment with Dr. Rock. You will be contacted as soon as possible by e-mail or telephone. ALL appointments MUST be confirmed by telephone. DO NOT use this form to request urgent/emergent visits. To request general information, click here.

First Name: (*)

Last Name: (*)

Daytime phone: (*)

Alternate phone:

E-mail address: (*)

(*) required fields

Preferred appointment date:

Month

Day

Year

or:

Day of the Week

Preferred appointment time

Comments / Special requests:

A confirmation window will appear once your request has been successfully submitted.