Request an Appointment with UnityPoint Health - Waterloo

UnityPoint Clinic Urgent Care ? North Crossing

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UnityPoint Clinic Urgent Care ? San Marnan

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Urgent Care - United Medical Park

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Urgent Care ? Prairie Parkway

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Allen Hospital

Request an Appointment

Convenient and compassionate health care is our goal. To request an appointment, please fill out this form and a representative from our team will contact you within two (2) business days or sooner.

Notice: Please do not use this form for urgent medical issues, same-day appointments or appointment cancellations. If this is a medical emergency, please call 9-1-1.













*First Name *Last Name *Name of Person Being Seen *Date Of Birth (MM/DD/YYYY) *New/Existing Patient: *What kind of appointment do you need?





 Reason for VisitPreferred Provider (if any)Or, you can select clinic location*Preferred Day



*Preferred Time



 *Email *Phone Number Preferred Method of Contact