For current and prospective patients interested in more information about xenotransplantation at MGH, please visit

icon showing high importanceTo ensure a smooth and expedited intake process: 

Please call Mass General registration at 866-211-6588, Monday-Friday, 8:00 am to 5:00 pm ET.

Please be sure to request that your nephrologist or primary care provider submit the following required documents via fax: 617-726-0822.

  • 2728 CMS ESRD form (if on chronic dialysis)
  • Recent nephrologist visit note
  • Recent ED discharge summary
  • Pertinent test results (e.g., kidney biopsy)
  • Insurance information

Please use this form only if:

  • You have never been a patient in the Kidney Transplant Program, OR
  • You have been a patient in the Kidney Transplant Program but are seeking an appointment with a new clinical area or doctor
Please call 911 if you are experiencing a medical emergency.

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

* indicates a required field.

Requestor Information

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

Patient Information


About Your Appointment

About Your First Appointment

Your first appointment with the Kidney Transplant Program will be a comprehensive pre-transplant evaluation that includes medical and surgical consultations, laboratory tests and specialized procedures to determine if you are a candidate for transplantation. Before we can schedule your pre-transplant evaluation, you will need to do the following:

  • Submit the secure form above
  • Obtain a Mass General Medical Record Number (MRN) — If you have not received care at Mass General in the last six months, or if you have never received care at Mass General, please call 1-866-211-6588 (toll free) to verify your information and/or obtain an MRN

After you submit the form, a kidney transplant nurse coordinator and a transplant nephrologist will review your information and call you back with the information you’ll need to make an appointment. You may also speak with a representative directly Monday–Friday, 8:00 am to 4:00 pm EST by calling 877-644-2860.

Download a PDF of the Kidney Transplant Program Roadmap >

Directions to the Kidney Transplant Evaluation Program