Request an Appointment

Become a new patient today by requesting an appointment with one of the providers from the drop down menu or by calling 860-358-4808.

If this is an emergency, please call 911.

Please note: We cannot process emergency requests from this form. If you are having a medical emergency, please call 911.

When you submit this form, your information will be sent to the appropriate Middlesex Health staff, who will help you schedule an appointment or complete your request.

All fields are required unless otherwise noted.

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Please choose the office you would like to be seen at.

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