CARLSMED, INC. (Form: 4, Received: 07/24/2025 20:47:40)

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	OMB APPROVAL OMB Number: 3235-0287 Estimated average burden hours per response... 0.5
	Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940

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 (MM/DD/YYYY) 7/24/2025
(Street) MENLO PARK, CA 94025	4. If Amendment, Date Original Filed (MM/DD/YYYY)	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. Trans. Date	2A. Deemed Execution Date, if any	3. Trans. 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)
1.Title of Security (Instr. 3)	2. Trans. Date	2A. Deemed Execution Date, if any	Code	V	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Common Stock	7/24/2025		C		2,948,794	A	⁽¹⁾	2,948,794	I	See footnote ⁽²⁾⁽³⁾⁽⁴⁾
Common Stock	7/24/2025		C		825,135	A	⁽¹⁾	3,773,929	I	See footnote ⁽²⁾⁽³⁾⁽⁴⁾
Common Stock	7/24/2025		C		531,877	A	⁽¹⁾	4,305,806	I	See footnote ⁽²⁾⁽³⁾⁽⁴⁾
Common Stock	7/24/2025		C		149,655	A	⁽¹⁾	149,655	I	See footnote ⁽³⁾⁽⁴⁾⁽⁵⁾
Common Stock	7/24/2025		C		41,876	A	⁽¹⁾	191,531	I	See footnote ⁽³⁾⁽⁴⁾⁽⁵⁾
Common Stock	7/24/2025		C		26,993	A	⁽¹⁾	218,524	I	See footnote ⁽³⁾⁽⁴⁾⁽⁵⁾
Common Stock	7/24/2025		C		1,117,743	A	⁽¹⁾	1,117,743	I	See footnote ⁽³⁾⁽⁴⁾⁽⁶⁾

*Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)*
1. Title of Derivate Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Trans. Date	3A. Deemed Execution Date, if any	4. Trans. 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		7. Title and Amount of Securities Underlying Derivative Security (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)
1. Title of Derivate Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Trans. Date	3A. Deemed Execution Date, if any	Code	V	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)			11. Nature of Indirect Beneficial Ownership (Instr. 4)
Preferred Series A Stock	⁽¹⁾	7/24/2025		C			2,948,794	⁽¹⁾	⁽¹⁾	Common Stock	2,948,794	$0	0	I	See footnotes ⁽²⁾⁽³⁾⁽⁴⁾
Preferred Series B Stock	⁽¹⁾	7/24/2025		C			825,135	⁽¹⁾	⁽¹⁾	Common Stock	825,135	$0	0	I	See footnotes ⁽²⁾⁽³⁾⁽⁴⁾
Preferred Series C Stock	⁽¹⁾	7/24/2025		C			531,877	⁽¹⁾	⁽¹⁾	Common Stock	531,877	$0	0	I	See footnotes ⁽²⁾⁽³⁾⁽⁴⁾
Preferred Series A Stock	⁽¹⁾	7/24/2025		C			149,655	⁽¹⁾	⁽¹⁾	Common Stock	149,655	$0	0	I	See footnotes ⁽³⁾⁽⁴⁾⁽⁵⁾
Preferred Stock Series B	⁽¹⁾	7/24/2025		C			41,876	⁽¹⁾	⁽¹⁾	Common Stock	41,876	$0	0	I	See footnotes ⁽³⁾⁽⁴⁾⁽⁵⁾
Preferred Series C Stock	⁽¹⁾	7/24/2025		C			26,993	⁽¹⁾	⁽¹⁾	Common Stock	26,993	$0	0	I	See footnotes ⁽³⁾⁽⁴⁾⁽⁵⁾
Preferred Series C Stock	⁽¹⁾	7/24/2025		C			1,117,743	⁽¹⁾	⁽¹⁾	Common Stock	1,117,743	$0	0	I	See footnotes ⁽³⁾⁽⁴⁾⁽⁶⁾

Explanation of Responses:
(1)	These shares of preferred stock are reported after giving effect to the 1-for-5.58 reverse split of the Issuer's common and preferred stock effected on July 10, 2025 (the "Reverse Split"). Each share of Series A Preferred Stock, Series B Preferred Stock, and Series C Preferred Stock is convertible into one share of the Issuer's common stock immediately prior to the closing of the Issuer's initial public offering. These shares are reported in Table II above on an as-converted 1-to-1 basis with no additional consideration and have no expiration date.
(2)	Stock held by U.S. Venture Partners XII, L.P. ("USVP XII").
(3)	Presidio Management Group XII, L.L.C ("PMG XII") is the general partner of USVP XII and U.S. Venture Partners XII-A, L.P. ("USVP XII-A", and together with USVP XII, the "USVP XII Funds"). Presidio Management Group Select Fund I, L.L.C ("PMG SFI", and, together with USVP XII, USVP XII-A, U.S. Venture Partners Select Fund I, L.P. ("USVP SFI"), U.S. Venture Partners Select Fund I-A, L.P. ("USVP SFI-A"), and PMG XII, "USVP") is the general partner of USVP SFI and USVP SFI-A. PMG XII and PMG SFI may be deemed to share voting and dispositive power over the stock held by USVP.
(4)	Each of Jonathan D. Root, Richard W. Lewis, Dafina Toncheva and Steven M. Krausz, are managing members of PMG XII, who may be deemed to share voting and dispositive power over the reported securities held by the USVP XII Funds. In addition, Casey M. Tansey is the managing partner of PMG XII and may be deemed to share voting and dispositive power over the reported securities held by the USVP XII Funds. Each such persons and entities disclaim beneficial ownership of the reported securities held by the USVP XII Funds, except to the extent of any pecuniary interest therein.
(5)	Stock Held by USVP XII-A.
(6)	Stock held by USVP SFI, on its own behalf and as nominee for USVP SFI-A.

Reporting Owners
Reporting Owner Name / Address	Relationships
Reporting Owner Name / Address	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		7/24/2025
^**Signature of Reporting Person		Date
/s/ Dale Holladay, Authorized Signatory on behalf of U.S. Venture Partners XII, L.P.		7/24/2025
^**Signature of Reporting Person		Date
/s/ Dale Holladay, Attorney-in-Fact for Casey M. Tansey		7/24/2025
^**Signature of Reporting Person		Date

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