Neurology Physician Referral at Massachusetts General Hospital

Please submit the secure form below to refer your patient to a Neurology provider at Massachusetts General Hospital. This form should not be used for appointments needed within 72 hours. For more urgent needs, please call 855-644-6387.

After you submit this form, our care team will work directly with the patient to schedule an appointment and assist with registration as needed. Referring providers will be notified of appointment details. You may also call 855-644-6387 to speak with a member of our team Monday–Friday, 8:30 am to 5:00 pm EST.

Note: Some questions on this form may appear or change based on your responses.

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