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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.

Trauma Surgery

Tufts Medical Center
800 Washington Street
Proger Building, 5th floor
Boston, MA 02111

  • Emergency Transfers
    Ph: (877) 872-8620
  • Admitting a Patient
    Ph: (877) 657-8387
  • Administrative Offices
    Ph: (617) 636-4488
    Fx: (617) 636-8172

* Indicates a required field.


Patient Information

Marital Status
Interpreter Required?

Insurance Information