Please submit the secure form below to request an appointment at the Swallowing, Heartburn and Esophageal Disease (SHED) Center at Massachusetts General Hospital.

After you submit the form, you will hear from one of our representatives within 24 business hours with information you’ll need to make an appointment. You may also speak with a representative directly Monday–Friday, 8:30 am to 5:00 pm EST by calling 617-724-1020.

Please use this form only if:
  • You have never been a SHED patient, OR
  • You have been a SHED patient but are seeking an appointment with a new clinical area or doctor

Important note: Some questions on this form may appear or disappear based on your responses.

* indicates a required field.

Please call 911 if you are experiencing a medical emergency.

Requestor Information

If you are an international patient, please complete the International Patient Appointment Form.

Patient Information


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