Skip to content
Follow us:UNI Urgent Care Instagram Icon/Link UNI Urgent Care Facebook Icon/Link

UNI Urgent Care Logo

  • COVID-19 Updates & Protocols
    • ZipPass – TeleHealth Appointment Scheduling
  • Locations
    • Frederick
    • Hagerstown I
    • Hagerstown II
    • Westminster I
    • Westminster II
  • Services
    • Urgent Care
    • Health Services
    • Occupational Medicine Services
    • Travel and Flu Vaccines
    • DOT Physicals
    • Physical Therapy
  • Patient Information
    • Insurance
    • Patient Intake Form
    • Online Bill Pay
  • Employment
    • Careers
  • News
  • Contact
  • x

Patient Intake Form

Make your intake even faster by PRINTING this form and bringing it with you.

UNI-Patient-Intake-Form-Download

  • Home
  • Services
  • Locations
  • Patient Information
  • Insurance
  • Online Bill Pay
  • Home
  • Services
  • Locations
  • Patient Information
  • Insurance
  • Online Bill Pay
UNI Urgent Care logo

© 2019 UNI Urgent Care.
ALL RIGHTS RESERVED | Privacy Policy
Wyoming Web Design

VA Authorized Urgent Care Provider
UNI Urgent Care Instagram Icon/Link UNI Urgent Care Facebook Icon/Link