Amendment to Statement of Changes in Beneficial Ownership (Form 4/A)

FORM 4 Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person * Presidio Management Group XII, L.L.C. 2. Issuer Name and Ticker or Trading Symbol CARLSMED, INC. [CARL] 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) _____ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below) (Last) (First) (Middle) C/O U.S. VENTURE PARTNERS, 1460 EL CAMINO REAL, SUITE 100 3. Date of Earliest Transaction (Month/Day/Year) 07/24/2025 (Street) MENLO PARK, CA 94025 4. If Amendment, Date Original Filed (Month/Day/Year) 07/24/2025 6. Individual or Joint/Group Filing (Check Applicable Line) ___ Form filed by One Reporting Person _X_ Form filed by More than One Reporting Person (City) (State) (Zip) Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1.Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4) Code V Amount (A) or (D) Price Common Stock 07/24/2025 P 200,000 A $15 200,000 I See footnote(1)

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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative Security (Instr. 3)

2. Conversion or Exercise Price of Derivative Security

3. Transaction Date (Month/Day/Year)

3A. Deemed Execution Date, if any (Month/Day/Year)

4. Transaction Code (Instr. 8)

5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5)

6. Date Exercisable and Expiration Date (Month/Day/Year)

7. Title and Amount of Underlying Securities (Instr. 3 and 4)

8. Price of Derivative Security (Instr. 5)

9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)

10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)

11. Nature of Indirect Beneficial Ownership (Instr. 4)

Code

V

(A)

(D)

Date Exercisable

Expiration Date

Title

Amount or Number of Shares

Reporting Owners

Reporting Owner Name / Address	Relationships
	Director	10% Owner	Officer	Other
Presidio Management Group XII, L.L.C. C/O U.S. VENTURE PARTNERS 1460 EL CAMINO REAL, SUITE 100 MENLO PARK, CA 94025		X
U.S. Venture Partners XII, L.P. 1460 EL CAMINO REAL, SUITE 100 MENLO PARK, CA 94025		X
Tansey Casey M 1460 EL CAMINO REAL, SUITE 100 MENLO PARK, CA 94025		X

Signatures

/s/ Dale Holladay, Authorized Signatory on behalf of Presidio Management Group		09/15/2026
**Signature of Reporting Person		Date
/s/ Dale Holladay, Authorized Signatory on behalf of U.S. Venture Partners XII, L.P.		09/15/2026
**Signature of Reporting Person		Date
/s/ Dale Holladay, Attorney-in-Fact for Casey M. Tansey		09/15/2026
**Signature of Reporting Person		Date

Explanation of Responses:

*	If the form is filed by more than one reporting person, see Instruction 4(b)(v).
**	Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
(1)	Stock held by Casey M. Tansey.
Remarks: On July 24, 2025, the Reporting Persons filed a Form 4 which, due to an administrative error, inadvertently omitted the purchase of common stock by Mr. Tansey and indicated that he did not directly own any shares of the Issuer's common stock. This Form 4 is being filed solely to correct that error and report the purchase by Mr. Tansey.

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