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 ›

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.

What to expect: One of our Chao Family Comprehensive Cancer Center referral specialists will call you back at a convenient time. We will respond by the next business day. We also recommend having your insurance details and any other pertinent information available.

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