Request an appointment online

Complete our secure online form to start the appointment process at Massachusetts General Hospital.

New Patients

Please use this form only if you are a new patient or are selecting a new Mass General doctor.

After you submit the form, a representative from the Physician Referral Service (PRS) will call you back with the information you’ll need to make an appointment. You may also speak with a PRS representative directly Monday–Friday, 8:30 am to 5:00 pm by calling 800-711-4644.

Medical Emergencies

Please call 911 if you are experiencing a medical emergency.

Required fields are marked with an*

Patient first name*   

Patient last name*   

Patient Mass General Medical Record Number, if known

Patient birth date (MMDDYYYY)*   

Daytime phone*   

E-mail address*   

City*   

State*   

Zip code*   

Country*   

Are you the patient?*   

If yes, skip to reason for your request. If no, what is your relationship to the patient?

Your first name (if you are not the patient)

Your last name (if you are not the patient)

Your phone number (if you are not the patient)

Reason for your request*   

Please provide additional details about your request, including the type of specialist, if applicable.*   

Preference for a female or male provider?*   




Billing information

Read more about Mass General's billing services and learn answers to questions you may have about your bill.

Patient confidentiality

Mass General places the highest priority on a patient’s right to privacy. Learn how medical information about you is used and disclosed.