Request an Appointment

As an alternative to phoning our offices for medical appointments, Bay Harbor Podiatry Group has established this portion of our Web site to allow you to request an appointment online. It is not for emergency situations. In the case of a true emergency, call 911 or go to the nearest hospital emergency room.

If you have an urgent foot problem, please call our office:

Bay Harbor Podiatry Group
Torrance Office: (310) 540-1213

We will respond to your online appointment request within 48 hours Monday - Friday during normal business hours. This service is for the patient who wants to make an appointment for the upcoming week or month - it is NOT for same day or next day appointments.

Due to the office being very busy at most times, appointments may take longer than expected to book for routine care, depending on the schedule for any given day.

To make an appointment, please complete this form online and click the "Send Request" button at the bottom of this page. *Required field.

Name of Patient: *

Patient's birthdate:

Patient's insurance:

Name of person making the appointment (if not the patient):

Relationship to patient:

Are you a first-time patient?

Yes No

I would like to make a non-urgent appointment with:

Physician	Availability
Marc G. Mittleman, D.P.M.	M-F 8:00 am - 5:00 pm
Michael S. Bloch, D.P.M.	M-F 8:00 am - 5:00 pm
Roland J. Carroll, III, D.P.M.	M-F 8:00 am - 5:00 pm

I need to see the doctor for:

I prefer the following day of the week:

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

I prefer an appointment at the following hour:

AM PM

If we have questions or there is a scheduling conflict please supply the following information:

Home Telephone Number: *

Work Telephone Number:

Cell Phone Number:

Your E-mail Address: *