Please fill out the form below to request an appointment with Massachusetts General Hospital's Thyroid Nodule Program.

  • You may also schedule an appointment by phone: 617-726-3872 (option 6)

Thank you for your interest in the Thyroid Nodule Program at Massachusetts General Hospital. Once we have received your completed form, our care coordinator will contact you within one business day to schedule an appointment with our next available clinician.

New Patient Registration

If you have never been a patient at Mass General, please call 1-866-211-6588 to register after submitting this form.

Required fields are marked with an*

Patient name*   

Date of birth*   

Preferred phone*   

Street address

City

State

Zip code

Email address

Primary insurance*   

Secondary insurance

Clinical History (check all that may apply)

I have been diagnosed with a thyroid nodule  
I have been seen by an endocrinologist  

Previous Testing (check all that may apply)

Thyroid ultrasound  
Biopsy of my thyroid nodule(s)  
Biopsy showed a suspicious or cancerous result  
Please provide a brief description of your condition and any information you think may be important for us to know, including primary care or referring physician information and additional previous testing (if any):