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Before you complete this form, please note:

  • Pittsburgh Mercy cannot address a medical emergency through this form. If you are having a crisis or a medical emergency, call 911 or go to your nearest hospital emergency room.
  • We value your privacy. To help protect your privacy, please do not include your Social Security Number, date of birth, or other confidential information in your message to us.
  • We cannot provide medical advice or opinions without a consultation.
  • We cannot respond to questions or comments from persons under the age of 18.
  • If you need to speak directly with your care provider, please call 1-877-637-2924.

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