USC Internal Medicine: Request an Appointment

Request an Appointment

If you are having an emergency, please call 911.

Please note: if you are not sure of the urgency of your problem or unsure of the appropriate Department to go to, feel free to contact us at our USC Internal Medicine Call Center at (323) 442-5100, 8 am to 5 pm. We will help you determine the urgency of your problem and/or help you select the appropriate Department/Specialist.

Please allow us 24 hours (or one business day) to process this request and to confirm your appointment.

To request an appointment, please enter your information below and press the "Send Appointment Request" button. If your browser does not support forms, or if you prefer to request an appointment by phone, please call our USC Internal Medicine Call Center at (323) 442-5100.

Please note that all patient information received will be kept confidential and will be transmitted through an encrypted channel.

(So that we can contact you for confirmation, fields marked with * are required)

Contact Information
*Is this your first time with us?	Yes No
*First Name:
Middle Initial:
*Last Name:
*Telephone:	- -
*E-mail Address:
Date of Birth (mm/dd/yyyy)*:
Street Address:
City:
State:
Zip Code:
Appointment Dates
First Choice (appointments must be scheduled at least 3 days in advance): Second Choice (appointments must be scheduled at least 3 days in advance): Third Choice (appointments must be scheduled at least 3 days in advance):

Preferred Time for Appointment:
A.M. P.M. No Preference
Reason for Appointment and/or Primary Complaint:

Location where you prefer your appointment:

Specialty division and physician you would like to see: