Make an Appointment


Appointment Request

Please do not use this form to schedule a COVID-19 vaccine appointment. For COVID-19 vaccine availability and scheduling, visit ›

Already a patient?

If you are an existing patient, please log into the patient portal to submit an appointment request ›

Please use this form only if you are a new patient or making an appointment for a patient. If this is a medical emergency, please dial 911.

After you submit your request, a UCI Health representative will contact you by phone within one business day to assist in making an appointment. We also recommend having your insurance information and any other pertinent information available.

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Make an Appointment


In this Section...

Request an Appointment

Patient Information
Are you the patient?

Contact Information
Best time to call you

Reason for Appointment