New Patient Appointment Request Form
Thank You for Choosing BIDMC
We are here to assist you before, during, and after your appointment.
New Patients
Please fill out the form below if you would like to become a new patient, and a BIDMC representative will contact you during regular business hours to schedule your first appointment.
Find a Specialist New Patient Form
Current Patients
The form below is for new patients only. For current patients: Please call your physician's office or use the MyBILH Chart patient portal to schedule your appointment online.
Looking for a Primary Care Provider (PCP)?
If you're new to BILH Primary Care, use our online appointment scheduler to set up your first primary care appointment.
New Patient Forms
Please choose the department for which you would like to schedule an appointment.
If you are experiencing a medical emergency, call 911. Please do not use any of these forms.
- Allergy
- Breast Care Center
- Cancer Genetics & Prevention Program
- Cardiac Surgery
- Cardiology
- Cardiovascular Medicine
- Chest Disease Center
- Colon & Rectal Surgery
- Dermatology
- ENT (Otalryngology)
- Endocrinology & Diabetes
- Gastroenterology
- General Surgery
- Gerontology
- Headache Center
- Hematology
- Infectious Disease
- Liver Center
- Liver Tumor Program
- Nephrology (Kidney)