Request an Appointment

If you're an established patient with University Hospitals, all of your health and contact information is already in UH MyChart. It's the easiest way to schedule your appointment. Click here to quickly set up or access your account.


If you're not an established patient, use the form below to request an appointment with a University Hospitals specialist. Our staff will follow up with you to confirm the appointment time, location, date and other details.


We are implementing our new electronic health record (EHR) and our response time for appointment requests may take longer than usual. We apologize for any inconvenience and we will respond to your request as quickly as possible.


If you are experiencing a medical emergency, please call 9-1-1.


* Indicates required field


Appointment Information


Provider Name
Specialty
  
Have you seen this provider in the last 3 years?

Select At Least One

Preferred Time of Day

Select At Least One

Preferred Day

Select At Least One

Preferred Location

Select At Least One

Patient information:

Legal Sex

Address[Optional]

City[Optional]

State[Optional]

ZipCode[Optional]

Contact information:

Insurance information:

Myself
Someone Else


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