To request an appointment with one of the Orthopaedic Trauma doctors, please use the form below.

If you were seen in the Emergency Room and/or you have an URGENT appointment request, DO NOT use this form to request an appointment. Call 617-726-9111 to schedule your appointment.

If you do not have a Mass General medical record number, you will need to call 1-866-211-6588 to register and obtain one before we can schedule your appointment. A manager will be in touch to schedule your appointment.

Required fields are marked with an*


Date of birth*   

Phone number*   

Email address

Mass General Medical Record Number (Pre-registration required, call 1-866-211-6588)*   

Name of your referring physician

To request a specific doctor, list name below

Reason for visit

Insurance Plan