Request an Appointment

Dr. Loftus can treat patients in the Houston, TX and surrounding areas while offering availability for remote appointments.

Appointment Request Form

Individual Information

Please enter your information to request an appointment with Dr. Loftus.

How can we help? (Select your gender to display aditional options)

What are the reasons you are requesting to see Dr. Loftus? (You can check multiple reasons)

How Did You Hear About Dr. Loftus?

Additional Information

Is there any other information that you would like to tell us? (Symptoms, prior or current doctors that you see for the conditions, treatments you have tried, etc.)

Privacy policy: No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. All the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties.

SMS disclaimer: By providing a telephone number and submitting the form you are consenting to be contacted by SMS text message (our message frequency may vary). Message & data rates may apply. Reply STOP to opt-out of further messaging. Reply HELP for more information. See our Privacy Policy.