The Houston Methodist Woodlands campus took over an existing vacant building formerly a Charming Charlie’s and YES Fitness as the new location for their Sports Medicine program. It is always a challenge to go into an existing building with existing utilities and conditions that impact the design. One of the main goals of the project was to utilize as much of the existing building as we could while still giving the community the best Sports Medicine program in the area. A challenge that we found in working with the existing building was trying to determine the best spatial layout for the programmatic functions. We went through multiple planning iterations trying to incorporate as much of the existing building elements until we settled on the final layout. Additionally, the Owner desired a budget-friendly design which was achieved through the careful identification of material selection and the use of the existing building layout. We successfully worked with the construction manager at risk (CMAR) to meet the schedule and budget, while providing a positive patient experience from the parking lot into the gym.