Tools

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 Physician Access Line at 617-636-7255.

This form should only be filled out by physicians or their staff.

This site is not designed to and does not provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual. See more information.

In the case of a medical emergency, please call 911 for immediate assistance.


From your initial visit to the office, through surgery and to your discharge, we strive to make the entire surgical experience as comfortable as possible. To schedule an appointment please call 617-636-5025.

Division of Pediatric General Surgery

Tufts Medical Center
800 Washington Street
Floating Hospital, 2nd Floor
Boston, MA 02111

  • Phone: 617-636-5025
  • Fax: 617-636-8122


Pediatric General Surgery Satellite Clinics: 

Pediatric Specialty Center - Chelmsford
20 Research Place
North Chelmsford, MA  01863
978-937-6362

Pediatric Specialty Center - Framingham
85 Lincoln Street, 4th Floor
Framingham, MA  01702
866-618-5518

Pediatric Specialty Center - Lawrence
25 Marston Street, Suite 206
Lawrence, MA  01842
978-208-4916

* Indicates a required field.

  
  
  
 
 
 

Patient Information


  
 
 
  
Gender
Marital Status
 
  
 
  
 
 
 
Interpreter Required?
 
 

Insurance Information


  
 
 
 

 
 

  Submit