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Refer a Patient to the Department of Urology 

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 Urology. 

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 857-238-3838.


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.

Patient Information




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Referring Physician














If you selected Physician Gateway above and are not currently enrolled, you will receive an email including enrollment instructions within 3 business days.  Physician Gateway is our secure online portal which enables you to submit referrals for patients, monitor patient status and order imaging tests

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