diff --git a/app.config.js b/app.config.js
new file mode 100644
index 0000000..7475ca0
--- /dev/null
+++ b/app.config.js
@@ -0,0 +1,97 @@
+export default {
+  expo: {
+    name: "health-app",
+    slug: "health-app",
+    version: "1.0.0",
+    orientation: "portrait",
+    icon: "./assets/images/icon.png",
+    scheme: "myapp",
+    userInterfaceStyle: "automatic",
+    newArchEnabled: true,
+    jsEngine: "hermes",
+    ios: {
+      supportsTablet: true,
+      config: {
+        usesNonExemptEncryption: false,
+      },
+      bundleIdentifier: "com.vinta.healthapp",
+      infoPlist: {
+        UIBackgroundModes: ["remote-notification"],
+      },
+    },
+    android: {
+      adaptiveIcon: {
+        foregroundImage: "./assets/images/adaptive-icon.png",
+        backgroundColor: "#ffffff",
+      },
+      permissions: [
+        "android.permission.RECORD_AUDIO",
+        "android.permission.RECEIVE_BOOT_COMPLETED",
+        "android.permission.SCHEDULE_EXACT_ALARM",
+        "android.permission.POST_NOTIFICATIONS",
+        "android.permission.USE_FULL_SCREEN_INTENT",
+      ],
+      package: "com.vinta.healthapp",
+      googleServicesFile: process.env.GOOGLE_SERVICES_JSON || "./_dev/google-services.json",
+    },
+    web: {
+      bundler: "metro",
+      output: "static",
+      favicon: "./assets/images/favicon.png",
+    },
+    plugins: [
+      "expo-router",
+      [
+        "expo-splash-screen",
+        {
+          image: "./assets/images/splash-icon.png",
+          imageWidth: 200,
+          resizeMode: "contain",
+          backgroundColor: "#ffffff",
+        },
+      ],
+      [
+        "expo-secure-store",
+        {
+          requireAuthentication: false,
+        },
+      ],
+      [
+        "expo-image-picker",
+        {
+          photosPermission:
+            "The app needs media access when you want to attach media to your messages.",
+          cameraPermission:
+            "The app needs camera access when you want to attach media to your messages.",
+          microphonePermission:
+            "The app needs microphone access when you want to attach media to your messages.",
+        },
+      ],
+      [
+        "expo-video",
+        {
+          supportsBackgroundPlayback: true,
+          supportsPictureInPicture: true,
+        },
+      ],
+      [
+        "expo-notifications",
+        {
+          icon: "./assets/images/adaptive-icon.png",
+          color: "#ffffff",
+        },
+      ],
+    ],
+    experiments: {
+      typedRoutes: true,
+    },
+    extra: {
+      router: {
+        origin: false,
+      },
+      eas: {
+        projectId: "b90347a9-ca6d-4949-9545-82fcce6ed6aa",
+      },
+    },
+  },
+};
diff --git a/app.json b/app.json
deleted file mode 100644
index e210040..0000000
--- a/app.json
+++ /dev/null
@@ -1,79 +0,0 @@
-{
-  "expo": {
-    "name": "health-app",
-    "slug": "health-app",
-    "version": "1.0.0",
-    "orientation": "portrait",
-    "icon": "./assets/images/icon.png",
-    "scheme": "myapp",
-    "userInterfaceStyle": "automatic",
-    "newArchEnabled": true,
-    "jsEngine": "hermes",
-    "ios": {
-      "supportsTablet": true,
-      "config": {
-        "usesNonExemptEncryption": false
-      },
-      "bundleIdentifier": "com.vinta.healthapp"
-    },
-    "android": {
-      "adaptiveIcon": {
-        "foregroundImage": "./assets/images/adaptive-icon.png",
-        "backgroundColor": "#ffffff"
-      },
-      "permissions": [
-        "android.permission.RECORD_AUDIO"
-      ],
-      "package": "com.vinta.healthapp"
-    },
-    "web": {
-      "bundler": "metro",
-      "output": "static",
-      "favicon": "./assets/images/favicon.png"
-    },
-    "plugins": [
-      "expo-router",
-      [
-        "expo-splash-screen",
-        {
-          "image": "./assets/images/splash-icon.png",
-          "imageWidth": 200,
-          "resizeMode": "contain",
-          "backgroundColor": "#ffffff"
-        }
-      ],
-      [
-        "expo-secure-store",
-        {
-          "requireAuthentication": false
-        }
-      ],
-      [
-        "expo-image-picker",
-        {
-          "photosPermission": "The app needs media access when you want to attach media to your messages.",
-          "cameraPermission": "The app needs camera access when you want to attach media to your messages.",
-          "microphonePermission": "The app needs microphone access when you want to attach media to your messages."
-        }
-      ],
-      [
-        "expo-video",
-        {
-          "supportsBackgroundPlayback": true,
-          "supportsPictureInPicture": true
-        }
-      ]
-    ],
-    "experiments": {
-      "typedRoutes": true
-    },
-    "extra": {
-      "router": {
-        "origin": false
-      },
-      "eas": {
-        "projectId": "b90347a9-ca6d-4949-9545-82fcce6ed6aa"
-      }
-    }
-  }
-}
diff --git a/app/(app)/_layout.tsx b/app/(app)/_layout.tsx
index 57cf7d1..2d32566 100644
--- a/app/(app)/_layout.tsx
+++ b/app/(app)/_layout.tsx
@@ -1,14 +1,24 @@
 import { useMedplumContext } from "@medplum/react-hooks";
 import { Redirect, Slot } from "expo-router";
+import { useEffect } from "react";
 
 import { LoadingScreen } from "@/components/LoadingScreen";
 import { PractitionerBanner } from "@/components/PractitionerBanner";
 import { ChatProvider } from "@/contexts/ChatContext";
+import { useNotifications } from "@/contexts/NotificationsContext";
 
 export default function AppLayout() {
   const { medplum, profile } = useMedplumContext();
+  const { setUpPushNotifications } = useNotifications();
   const isPractitioner = profile?.resourceType === "Practitioner";
 
+  useEffect(() => {
+    if (profile && medplum.getActiveLogin()) {
+      // Set up push notifications when user is logged in
+      setUpPushNotifications();
+    }
+  }, [medplum, profile, setUpPushNotifications]);
+
   if (medplum.isLoading()) {
     return <LoadingScreen />;
   }
diff --git a/app/_layout.tsx b/app/_layout.tsx
index 6425af6..f2d1a55 100644
--- a/app/_layout.tsx
+++ b/app/_layout.tsx
@@ -22,6 +22,7 @@ import {
 } from "react-native-safe-area-context";
 
 import { GluestackUIProvider } from "@/components/gluestack-ui-provider";
+import { NotificationsProvider } from "@/contexts/NotificationsContext";
 import { oauth2ClientId } from "@/utils/medplum-oauth2";
 
 export const unstable_settings = {
@@ -60,15 +61,17 @@ export default function RootLayout() {
         <StatusBar />
         <SafeAreaView className="h-full bg-background-0 md:w-full">
           <MedplumProvider medplum={medplum}>
-            <GestureHandlerRootView className="flex-1">
-              <Stack
-                screenOptions={{
-                  headerShown: false,
-                  // Prevents flickering:
-                  animation: "none",
-                }}
-              />
-            </GestureHandlerRootView>
+            <NotificationsProvider>
+              <GestureHandlerRootView className="flex-1">
+                <Stack
+                  screenOptions={{
+                    headerShown: false,
+                    // Prevents flickering:
+                    animation: "none",
+                  }}
+                />
+              </GestureHandlerRootView>
+            </NotificationsProvider>
           </MedplumProvider>
         </SafeAreaView>
       </SafeAreaProvider>
diff --git a/contexts/NotificationsContext.tsx b/contexts/NotificationsContext.tsx
new file mode 100644
index 0000000..2992c42
--- /dev/null
+++ b/contexts/NotificationsContext.tsx
@@ -0,0 +1,161 @@
+import { MedplumClient } from "@medplum/core";
+import { useMedplum } from "@medplum/react-hooks";
+import Constants from "expo-constants";
+import * as Device from "expo-device";
+import * as Notifications from "expo-notifications";
+import { router } from "expo-router";
+import { createContext, useCallback, useContext, useEffect, useRef, useState } from "react";
+import { Platform } from "react-native";
+
+Notifications.setNotificationHandler({
+  handleNotification: async () => ({
+    shouldShowAlert: true,
+    shouldPlaySound: true,
+    shouldSetBadge: true,
+  }),
+});
+
+interface NotificationsContextType {
+  isNotificationsEnabled: boolean;
+  setUpPushNotifications: () => Promise<boolean>;
+}
+
+const NotificationsContext = createContext<NotificationsContextType>({
+  isNotificationsEnabled: false,
+  setUpPushNotifications: async () => false,
+});
+
+async function registerForPushNotificationsAsync() {
+  let token;
+
+  if (!Device.isDevice) {
+    return;
+  }
+
+  if (Platform.OS === "android") {
+    await Notifications.setNotificationChannelAsync("default", {
+      name: "default",
+      importance: Notifications.AndroidImportance.MAX,
+      vibrationPattern: [0, 250, 250, 250],
+      lightColor: "#FF231F7C",
+    });
+  }
+
+  try {
+    const projectId = Constants.expoConfig?.extra?.eas?.projectId;
+    if (!projectId) {
+      throw new Error("Missing EAS project ID");
+    }
+
+    token = await Notifications.getExpoPushTokenAsync({
+      projectId,
+    });
+    return token?.data;
+  } catch (error) {
+    console.error("Error getting push token:", error);
+  }
+}
+
+function updateMedplumPushToken(medplum: MedplumClient, token: string): Promise<void> {
+  return (async () => {
+    try {
+      const profile = medplum.getProfile();
+      if (!profile) return;
+
+      // Check if token already exists and matches
+      const existingToken = profile.extension?.find(
+        (e) => e.url === "https://medplum.com/push-token",
+      )?.valueString;
+
+      if (existingToken === token) {
+        return; // Token hasn't changed, no need to update
+      }
+
+      // Update the token
+      const extensions =
+        profile.extension?.filter((e) => e.url !== "https://medplum.com/push-token") || [];
+      extensions.push({
+        url: "https://medplum.com/push-token",
+        valueString: token,
+      });
+      await medplum.updateResource({
+        ...profile,
+        extension: extensions,
+      });
+    } catch (error) {
+      console.error("Error updating push token in Medplum:", error);
+    }
+  })();
+}
+
+function handleMessageNotificationInteraction(response: Notifications.NotificationResponse) {
+  const data = response.notification.request.content.data;
+  if (data.threadId) {
+    router.push(`/thread/${data.threadId}`);
+  }
+}
+
+export function NotificationsProvider({ children }: { children: React.ReactNode }) {
+  const [isNotificationsEnabled, setIsNotificationsEnabled] = useState(false);
+  const responseListener = useRef<Notifications.EventSubscription>();
+  const medplum = useMedplum();
+
+  const setUpPushNotifications = useCallback(async () => {
+    // Check and request notification permissions
+    const { status: existingStatus } = await Notifications.getPermissionsAsync();
+    let finalStatus = existingStatus;
+    if (existingStatus !== "granted") {
+      ({ status: finalStatus } = await Notifications.requestPermissionsAsync());
+    }
+
+    // Set up push notifications if we have permission
+    const isEnabled = finalStatus === "granted";
+    setIsNotificationsEnabled(isEnabled);
+    if (isEnabled) {
+      const token = await registerForPushNotificationsAsync();
+      if (token) {
+        await updateMedplumPushToken(medplum, token);
+      }
+
+      // Set up notification listeners
+      responseListener.current = Notifications.addNotificationResponseReceivedListener(
+        handleMessageNotificationInteraction,
+      );
+    }
+    return isEnabled;
+  }, [medplum]);
+
+  // Effect to handle notifications when app is terminated
+  useEffect(() => {
+    const getInitialNotification = async () => {
+      const lastNotificationResponse = await Notifications.getLastNotificationResponseAsync();
+      if (lastNotificationResponse) {
+        handleMessageNotificationInteraction(lastNotificationResponse);
+      }
+    };
+
+    getInitialNotification();
+  }, []);
+
+  // Cleanup
+  useEffect(() => {
+    return () => {
+      responseListener.current?.remove();
+    };
+  }, [responseListener]);
+
+  return (
+    <NotificationsContext.Provider
+      value={{
+        isNotificationsEnabled,
+        setUpPushNotifications,
+      }}
+    >
+      {children}
+    </NotificationsContext.Provider>
+  );
+}
+
+export function useNotifications() {
+  return useContext(NotificationsContext);
+}
diff --git a/package-lock.json b/package-lock.json
index e0053be..8651d03 100644
--- a/package-lock.json
+++ b/package-lock.json
@@ -50,15 +50,17 @@
         "expo": "^52.0.23",
         "expo-auth-session": "~6.0.1",
         "expo-blur": "~14.0.3",
-        "expo-constants": "~17.0.3",
+        "expo-constants": "~17.0.5",
         "expo-crypto": "~14.0.1",
         "expo-dev-client": "~5.0.10",
+        "expo-device": "~7.0.2",
         "expo-file-system": "~18.0.7",
         "expo-font": "~13.0.2",
         "expo-haptics": "~14.0.0",
         "expo-image": "~2.0.4",
         "expo-image-picker": "~16.0.4",
         "expo-linking": "~7.0.3",
+        "expo-notifications": "~0.29.13",
         "expo-router": "~4.0.15",
         "expo-secure-store": "~14.0.1",
         "expo-sharing": "~13.0.1",
@@ -3265,6 +3267,12 @@
         "url": "https://github.com/sponsors/nzakas"
       }
     },
+    "node_modules/@ide/backoff": {
+      "version": "1.0.0",
+      "resolved": "https://registry.npmjs.org/@ide/backoff/-/backoff-1.0.0.tgz",
+      "integrity": "sha512-F0YfUDjvT+Mtt/R4xdl2X0EYCHMMiJqNLdxHD++jDT5ydEFIyqbCHh51Qx2E211dgZprPKhV7sHmnXKpLuvc5g==",
+      "license": "MIT"
+    },
     "node_modules/@internationalized/date": {
       "version": "3.6.0",
       "resolved": "https://registry.npmjs.org/@internationalized/date/-/date-3.6.0.tgz",
@@ -7182,6 +7190,19 @@
       "integrity": "sha512-BSHWgDSAiKs50o2Re8ppvp3seVHXSRM44cdSsT9FfNEUUZLOGWVCsiWaRPWM1Znn+mqZ1OfVZ3z3DWEzSp7hRA==",
       "license": "MIT"
     },
+    "node_modules/assert": {
+      "version": "2.1.0",
+      "resolved": "https://registry.npmjs.org/assert/-/assert-2.1.0.tgz",
+      "integrity": "sha512-eLHpSK/Y4nhMJ07gDaAzoX/XAKS8PSaojml3M0DM4JpV1LAi5JOJ/p6H/XWrl8L+DzVEvVCW1z3vWAaB9oTsQw==",
+      "license": "MIT",
+      "dependencies": {
+        "call-bind": "^1.0.2",
+        "is-nan": "^1.3.2",
+        "object-is": "^1.1.5",
+        "object.assign": "^4.1.4",
+        "util": "^0.12.5"
+      }
+    },
     "node_modules/ast-types": {
       "version": "0.16.1",
       "resolved": "https://registry.npmjs.org/ast-types/-/ast-types-0.16.1.tgz",
@@ -7521,6 +7542,12 @@
         "@babel/core": "^7.0.0"
       }
     },
+    "node_modules/badgin": {
+      "version": "1.2.3",
+      "resolved": "https://registry.npmjs.org/badgin/-/badgin-1.2.3.tgz",
+      "integrity": "sha512-NQGA7LcfCpSzIbGRbkgjgdWkjy7HI+Th5VLxTJfW5EeaAf3fnS+xWQaQOCYiny+q6QSvxqoSO04vCx+4u++EJw==",
+      "license": "MIT"
+    },
     "node_modules/balanced-match": {
       "version": "1.0.2",
       "resolved": "https://registry.npmjs.org/balanced-match/-/balanced-match-1.0.2.tgz",
@@ -8875,7 +8902,6 @@
       "version": "1.2.1",
       "resolved": "https://registry.npmjs.org/define-properties/-/define-properties-1.2.1.tgz",
       "integrity": "sha512-8QmQKqEASLd5nx0U1B1okLElbUuuttJ/AnYmRXbbbGDWh6uS208EjD4Xqq/I9wK7u0v6O08XhTWnt5XtEbR6Dg==",
-      "dev": true,
       "license": "MIT",
       "dependencies": {
         "define-data-property": "^1.0.1",
@@ -10299,9 +10325,9 @@
       }
     },
     "node_modules/expo-constants": {
-      "version": "17.0.4",
-      "resolved": "https://registry.npmjs.org/expo-constants/-/expo-constants-17.0.4.tgz",
-      "integrity": "sha512-5c0VlZycmDyQUCMCr3Na3cpHAsVJJ+5o6KkkD4rmATQZ0++Xp/S2gpnjWyEo2riRmO91vxoyHwmAySXuktJddQ==",
+      "version": "17.0.5",
+      "resolved": "https://registry.npmjs.org/expo-constants/-/expo-constants-17.0.5.tgz",
+      "integrity": "sha512-6SHXh32jCB+vrp2TRDNkoGoM421eOBPZIXX9ixI0hKKz71tIjD+LMr/P+rGUd/ks312MP3WK3j5vcYYPkCD8tQ==",
       "license": "MIT",
       "dependencies": {
         "@expo/config": "~10.0.8",
@@ -10392,6 +10418,44 @@
         "expo": "*"
       }
     },
+    "node_modules/expo-device": {
+      "version": "7.0.2",
+      "resolved": "https://registry.npmjs.org/expo-device/-/expo-device-7.0.2.tgz",
+      "integrity": "sha512-0PkTixE4Qi8VQBjixnj4aw2f6vE4tUZH7GK8zHROGKlBypZKcWmsA+W/Vp3RC5AyREjX71pO/hjKTSo/vF0E2w==",
+      "license": "MIT",
+      "dependencies": {
+        "ua-parser-js": "^0.7.33"
+      },
+      "peerDependencies": {
+        "expo": "*"
+      }
+    },
+    "node_modules/expo-device/node_modules/ua-parser-js": {
+      "version": "0.7.40",
+      "resolved": "https://registry.npmjs.org/ua-parser-js/-/ua-parser-js-0.7.40.tgz",
+      "integrity": "sha512-us1E3K+3jJppDBa3Tl0L3MOJiGhe1C6P0+nIvQAFYbxlMAx0h81eOwLmU57xgqToduDDPx3y5QsdjPfDu+FgOQ==",
+      "funding": [
+        {
+          "type": "opencollective",
+          "url": "https://opencollective.com/ua-parser-js"
+        },
+        {
+          "type": "paypal",
+          "url": "https://paypal.me/faisalman"
+        },
+        {
+          "type": "github",
+          "url": "https://github.com/sponsors/faisalman"
+        }
+      ],
+      "license": "MIT",
+      "bin": {
+        "ua-parser-js": "script/cli.js"
+      },
+      "engines": {
+        "node": "*"
+      }
+    },
     "node_modules/expo-file-system": {
       "version": "18.0.7",
       "resolved": "https://registry.npmjs.org/expo-file-system/-/expo-file-system-18.0.7.tgz",
@@ -10572,6 +10636,26 @@
         "invariant": "^2.2.4"
       }
     },
+    "node_modules/expo-notifications": {
+      "version": "0.29.13",
+      "resolved": "https://registry.npmjs.org/expo-notifications/-/expo-notifications-0.29.13.tgz",
+      "integrity": "sha512-GHye6XeI1uEeVttJO/hGwUyA5cgQsxR3mi5q37yOE7cZN3cMj36pIfEEmjXEr0nWIWSzoJ0w8c2QxNj5xfP1pA==",
+      "license": "MIT",
+      "dependencies": {
+        "@expo/image-utils": "^0.6.4",
+        "@ide/backoff": "^1.0.0",
+        "abort-controller": "^3.0.0",
+        "assert": "^2.0.0",
+        "badgin": "^1.1.5",
+        "expo-application": "~6.0.2",
+        "expo-constants": "~17.0.5"
+      },
+      "peerDependencies": {
+        "expo": "*",
+        "react": "*",
+        "react-native": "*"
+      }
+    },
     "node_modules/expo-router": {
       "version": "4.0.17",
       "resolved": "https://registry.npmjs.org/expo-router/-/expo-router-4.0.17.tgz",
@@ -12263,6 +12347,22 @@
         "url": "https://github.com/sponsors/ljharb"
       }
     },
+    "node_modules/is-nan": {
+      "version": "1.3.2",
+      "resolved": "https://registry.npmjs.org/is-nan/-/is-nan-1.3.2.tgz",
+      "integrity": "sha512-E+zBKpQ2t6MEo1VsonYmluk9NxGrbzpeeLC2xIViuO2EjU2xsXsBPwTr3Ykv9l08UYEVEdWeRZNouaZqF6RN0w==",
+      "license": "MIT",
+      "dependencies": {
+        "call-bind": "^1.0.0",
+        "define-properties": "^1.1.3"
+      },
+      "engines": {
+        "node": ">= 0.4"
+      },
+      "funding": {
+        "url": "https://github.com/sponsors/ljharb"
+      }
+    },
     "node_modules/is-negative-zero": {
       "version": "2.0.3",
       "resolved": "https://registry.npmjs.org/is-negative-zero/-/is-negative-zero-2.0.3.tgz",
@@ -15745,6 +15845,22 @@
         "url": "https://github.com/sponsors/ljharb"
       }
     },
+    "node_modules/object-is": {
+      "version": "1.1.6",
+      "resolved": "https://registry.npmjs.org/object-is/-/object-is-1.1.6.tgz",
+      "integrity": "sha512-F8cZ+KfGlSGi09lJT7/Nd6KJZ9ygtvYC0/UYYLI9nmQKLMnydpB9yvbv9K1uSkEu7FU9vYPmVwLg328tX+ot3Q==",
+      "license": "MIT",
+      "dependencies": {
+        "call-bind": "^1.0.7",
+        "define-properties": "^1.2.1"
+      },
+      "engines": {
+        "node": ">= 0.4"
+      },
+      "funding": {
+        "url": "https://github.com/sponsors/ljharb"
+      }
+    },
     "node_modules/object-keys": {
       "version": "1.1.1",
       "resolved": "https://registry.npmjs.org/object-keys/-/object-keys-1.1.1.tgz",
@@ -15758,7 +15874,6 @@
       "version": "4.1.5",
       "resolved": "https://registry.npmjs.org/object.assign/-/object.assign-4.1.5.tgz",
       "integrity": "sha512-byy+U7gp+FVwmyzKPYhW2h5l3crpmGsxl7X2s8y43IgxvG4g3QZ6CffDtsNQy1WsmZpQbO+ybo0AlW7TY6DcBQ==",
-      "dev": true,
       "license": "MIT",
       "dependencies": {
         "call-bind": "^1.0.5",
diff --git a/package.json b/package.json
index 63d6480..3c9be8f 100644
--- a/package.json
+++ b/package.json
@@ -80,7 +80,7 @@
     "expo": "^52.0.23",
     "expo-auth-session": "~6.0.1",
     "expo-blur": "~14.0.3",
-    "expo-constants": "~17.0.3",
+    "expo-constants": "~17.0.5",
     "expo-crypto": "~14.0.1",
     "expo-dev-client": "~5.0.10",
     "expo-file-system": "~18.0.7",
@@ -114,7 +114,9 @@
     "react-native-webview": "13.12.5",
     "scheduler": "^0.25.0",
     "tailwindcss": "^3.4.17",
-    "use-context-selector": "^2.0.0"
+    "use-context-selector": "^2.0.0",
+    "expo-notifications": "~0.29.13",
+    "expo-device": "~7.0.2"
   },
   "devDependencies": {
     "@babel/core": "^7.26.0",