Request Patient Portal Access

Please fill in the Tufts Medical Center patient portal request form below to be authenticated and contacted by any and all of our patient portals. We ask that you fill in these fields so that we can authenticate your identity and help protect your health information. We look forward to better communicating with you about your health online. 

Personal Information
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Contact Information
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Portal Information
Which portal(s) would you like access to?
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How can we help you?
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