要求预约| Www.childrenshospital.org | Boston Children's Hospital

This form is fornon-urgent appointment requests only。如果这是一个医疗紧急事件,请先拨91。This form should not be used in an emergency. This form is being transmitted via a secure connection.

Si esto es una emergencia médica, por favor llame al 9-1-1. No utilize este formulario si esto es una emergencia. Este formulario se transmite a través de una conexión segura.

如果您有兴趣安排COVID-19疫苗，请访问MyChildren’s Patient Portalto schedule your appointment or call the scheduling line at 617-919-7102.

如果您是国际病人，请contact Global Services要求约会。Start now »

提交ting Form

患者信息

First Name

Please enter your first name

姓

Please enter your Last name

出生日期

请输入你的生日

国家

请选择您的原籍国

联系信息

First Name

请输入您的联系人的名字

姓

Please enter your contact's Last name

Email Address

Please enter your contact's Last name

Phone Number

Please enter your contact's Phone Number

Contact Permission

可以给我留言

约会详细信息

诊所或位置

Please select your desired group for this appointment

约会消息

Please tell us a little about your reason for visiting

形式控件

警告

要求预约