New Patient Appointment Request Form

Thank You for Choosing BIDMC

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We are here to assist you before, during, and after your appointment. Please fill out this form 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.

This form is for new patients only. For current patients: Please call your physician's office or use PatientSite to schedule your appointment online.

PatientSite

If you are experiencing a medical emergency, call 911. Please do not use this form.

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