Oral & Maxillofacial Surgery Physician Referral at Massachusetts General Hospital

This form is for referrals only. If you are a patient, please call 617-726-2740 to speak with a member of our team.

Please submit the secure form below to refer your patient to a provider in the Division of Oral and Maxillofacial Surgery and Dentistry at Massachusetts General Hospital. This form should not be used for appointments needed within 72 hours. For more urgent needs, please call 617-726-2740

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 617-726-2740 to speak with our team Monday–Friday, 8:00 am to 5:00 pm EST.

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

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