Request an Appointment

REQUEST AN APPOINTMENT

You may make an appointment by calling the department number directly, listed to the right, or by completing the form below for primary care medical appointments. We will make every effort to respond to your appointment request as soon we receive it, within no more than 24-48 hours.

New patients are encouraged to print and fill out a Patient Profile for their first appointment. If you are an existing patient, you can use this form to change or update your information, including your address.

Appointments for Optical Care, Dental Care, and Behavioral Health are not available online. Please call the department directly to schedule an appointment.

Dental 617-425-2050
Eye Care 617-425-2022
Behavioral Health 617-425-2062

Your Name*

Patient Name (If you are requesting an appointment for someone else.)

Relationship to Patient (If you are requesting an appointment for someone else.)

Your Email*

Your Phone Number*

Are you a new or existing patient?*
New Existing 

In which primary care medical department would you like an appointment?*

If you are a new patient, seeking specialty care, or are unsure of which department to make an appointment in, please call 617-425-2500 during business hours.

Type of appointment needed?*

Preferred Date(s)?

From:  
To:       

Preferred Time(s)?

Monday Tuesday Wednesday Thursday Friday Saturday
Morning
8 am - 12 pm
 Morning  Morning  Morning  Morning  Morning  Morning
Afternoon
12 pm to 5 pm
 Afternoon  Afternoon  Afternoon  Afternoon
Evening
5 pm to 8 pm
 Evening  Evening

How did you hear about us?*

Additional Comments (optional)