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Esophageal Disease Services — Request an Appointment

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

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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.

Our referral specialists at the UCI Health Digestive Health Institute (DHI) are available Monday through Friday to help you schedule an appointment.

Please complete this form to have a referral specialist call you back at a convenient time. We will respond by the next business day.

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