UIC Phone Intake Form

Please fill out the requested inputs

  • Script for UIC to end the call:

    If call answered BEFORE 4pm Monday through Friday:

    “Thank you for providing this information, one of our NEW PATIENT CARE COORDINATORS will return your call as soon as they
    finish taking care of the patient they’re currently with. They will be calling you back at repeat phone number provided by patient”

    If called answered AFTER 5pm Monday through Friday or on the weekends:

    “Thank you for providing this information, one of our NEW PATIENT CARE COORDINATORS will return your call as soon as possible
    as our offices are currently closed. They will be calling you back at repeat phone number provided by patient”