UCI Health will see you now: Welcome to our new co-workers and patients from Fountain Valley, Lakewood, Los Alamitos and Placentia-Linda! 

Online weight and health questionnaire

Complete our secure online weight and health questionnaire below. Your answers will assist our team in creating a personalized plan tailored to your specific needs.

Medical emergencies

Call 911 if you are experiencing an emergency. Do not use this form.




Please provide your typical day/food intake:


Please provide any additional information that you think is important to understanding you, your weight control challenges and your goals.

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888-454-8131