Please fill out the form below to request an appointment with the Thoracic Outlet Syndrome team in the Division of Thoracic Surgery at Massachusetts General Hospital. Also, our questionnaire must also be filled out and sent to us. Once we receive both forms, we will contact you to schedule an appointment.

Regarding insurance information, please call your insurance company before filling out this form to verify that Dr. Dean Donahue and Mass General are "in-network" for your plan. Please ask if a referral from a provider is required for you to see Dr. Donahue and to receive treatment at Mass General.

Our patients are important to us and we value connecting with each individual. However, this can cause delays in our response time. If you have not received a response from us, we encourage you to call us.

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

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Requestor Information

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

Patient Information


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