Virtual Emergency Department Appointment Pre-registration Form

Please confirm your/your dependent's eligibility before booking a Virtual Emergency Department appointment:

*indicates a required field.

Only patients who meet the above criteria are eligible for a Virtual Emergency Department appointment.

In confirming your/your dependent's eligibility you will be redirected to a custom registration page for MGH's virtual emergency department on the virtual care platform Maple.

If your/your dependent’s condition changes or worsens, please call 911 or visit the nearest Emergency Department immediately.
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