- You have never been a patient in the Living Liver Donor Program, OR
- You have been a patient in the Living Liver Donor Program but are seeking an appointment with a new clinical area or doctor
- Submit the secure form below
- Obtain a Mass General Medical Record Number (MRN). If you have never received care at Mass General or you are not sure, please call 1-866-211-6588 (toll free) to verify your information and/or obtain an MRN.
You may also speak with a representative directly Monday–Friday, 8:30 am to 5:00 pm EST by calling 617-643-6321.
Important note: Some questions on this form may appear or disappear based on your responses.
* indicates a required field.
Please call 911 if you are experiencing a medical emergency.