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Physician Access Intake Form (Providers + Staff Only)

Referring a patient has never been easier. Simply fill out our refer a patient form and one of our referral coordinators will immediately follow up with you. Having trouble? No problem. Just call our Adult Physician Access Line at 617-636-7255 or our Pediatric Physician Access Line at 617-636-1440.
In the case of a medical emergency, please call 911 for immediate assistance.

Adult Division of Physical Medicine and Rehabilitation

Tufts Medical Center
260 Tremont St.
Biewend Building, 14th Floor
Boston, MA 02111

Truex Plymouth
17 Aldrin Rd.
Plymouth, MA 02360

Tufts Medical Center Specialty Care - Quincy
1690 Crown Colony Dr.
Quincy, MA 02169 

  • Phone: 617-636-5631
  • Fax: 617-636-2551

  • Phone: 781-361-9220

  • Phone: 857-403-4600

* Indicates a required field.


Patient Information

Marital Status
Interpreter Required?

Insurance Information