Mass General Brigham for Children Physician Referral

Please submit the secure form below to refer your patient to Mass General Brigham for Children specialists. This form should not be used for appointments needed within 72 hours. For more urgent needs, please call 888-644-3211.

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 speak with a team member Monday–Friday, 8:30 am to 5:00 pm EST by calling 888-644-3211.

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