Please submit the secure form below to refer your patient to a provider at Mass General's Department of Urology. This form should not be used for appointments needed within 72 hours. In those cases, please call us at 857-238-3838.
To request a Non-Acute Inpatient Transfer please call 877-MD-REFER (877-637-3337).
After you submit this form, our office will work directly with the patient to schedule an appointment and assist with registration if needed. Referring providers will be notified of appointment details. You may also speak with a representative directly Monday – Friday, 8:30 am to 5:00 pm EST by calling 857-238-3838.
Important note: Some questions on this form may appear or disappear based on your responses.
* indicates a required field
Operations Update for Referring Providers
Updates regarding Mass General Urology's current state of operations, and how we are delivering care to our patients during the COVID pandemic.