Request an appointment: Pediatric Urology

This form is for new patients. All urology appointments require a doctor’s referral. Ask your child’s doctor to follow the instructions on our refer a patient page.

You probably have lots of questions, and we’re here to help you schedule your child’s first appointment.

Note: If you’d like to make a follow-up appointment with a UCSF provider your child has already seen, you can do so through MyChart.

If your child is having a medical emergency, call 911 or go to the nearest emergency room. This form is for non-urgent appointments only.

Security statement

Your privacy is important to us. The appointment form above is securely encrypted, so any information you submit can’t be read by others while it’s transmitted over the internet. Your information will be handled in accordance with California and federal privacy laws.

Please note that we do not provide medical advice or diagnoses by email.