Request an Appointment

Please Note: If this is an emergency, call 911 or go to the nearest emergency room. The form below does not immediately notify medical staff of a health concern.

Option 1: If you are a current UVA patient and use MyChart, you can reach your existing care team directly through the “Schedule an Appointment” quick link on the right side of your home page.

Option 2: You can call a representative at 434.924.0000 any time to be connected to a scheduler. Additional conversations may be needed to schedule the best appointment for you.

Option 3: Provide us with as much information as possible through the form below. A representative will call you for any additional information that may be needed to schedule your appointment. After three failed attempts to reach you, we will cancel and close out your request.

At this time, email and text messaging are NOT contact options for requesting an appointment.

Are you a medical professional looking to refer your patient? Refer your patient

* required fields

Patient Information

First Name *

Middle Name

Last Name *

Prior Name

Gender

Male Female

Date of Birth *

Reason For Appointment *
Maximum 600 characters

Characters remaining: 600

Contact Information

Primary Daytime Phone *

We will contact you at this number to help schedule the appointment.

May we leave a message? *

Yes No

Email Address *

Your email will only be used to confirm that we have received your appointment request.

Email Address (confirm) *