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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 ›
Already a patient?
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.
Our referral specialists at the UCI Health Digestive Health Institute (DHI) are available Monday through Friday to help you schedule an appointment.
What to expect: One of our 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.
An asterisk (*) indicates a required field.