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Refer a Patient to the Department of Orthopaedics 

To request a Non-Acute Inpatient Transfer please call:877-MD-REFER (877-637-3337)

Please complete our secure online form to refer your patient to a provider at Massachusetts General Hospital’s Department of Orthopaedics. 

Please use the form below to request an appointment for your patient. This form should not be used for appointments needed within 72 hours; in those cases, please call us at 617-726-2784.


After you submit this form, our office will work directly with the patient to schedule an appointment and assist with registration if needed. You may also speak with a representative directly Monday – Friday, 8:30 am to 5:00 pm EST by calling
617-726-2784.


If this is a Spine referral, please call our Spine Center at 617-724-8636

Patient Information



MM/DD/YYYY



Spine referral, please call our Spine Center 617-724-8636




Referring Physician












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