New Patient Appointment Request Form

Thank You for Choosing BIDMC

We are here to assist you before, during, and after your appointment.

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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.

MyBILH Chart

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.

Find a PCP   Schedule Online

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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.