Please use this form only if you are a new patient or making an appointment for a patient.
If you are an existing patient, please log in to the patient portal to submit your appointment request ›
After you submit your request, a UCI Health representative will contact you by phone within one business day to assist in making an appointment.
Call 911 if you are experiencing an emergency. Do not use this form.
Any questions? Call us at 877-UCI-DOCS (877-824-3627).
Sign up for our monthly e-newsletter and get the latest health tips and stories from our Live Well blog ›