Skip survey header

Department of Urology Appointment Request

Thank you for your interest in the UCLA Department of Urology. Please fill out the form below and one of our friendly staff will contact you to schedule an appointment.

You can also call our appointment scheduling number at (310) 794-7700 to make an appointment.
This question requires a valid email address.
I prefer to be contacted by *This question is required.
New reCAPTCHA