Request An Appointment | University of Utah Health

To request an appointment, please answer the questions below and click on the button labeled "Send Request". You will receive a response within one business day.

Questions? Ask us via email transgenderhealth@hsc.utah.edu.

Preferred Name:

First Name (Legal)*:

Last Name (Legal)*:

Age*:

Address:

City:

State:

Zip Code:

Email Address*:

Contact Number*:

Preferred Contact Method:

Phone Email

Relationship to Inquiring Person*:

Self Parent/Guardian Partner/Spouse Friend

Preferred Contact Time:

Requested Specialty:

Reason for Requested Visit:

Requested Provider Name:

Services & Treatments

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