Referring Physicians
Thank you for your patient referrals. We consider it a compliment that
you continue to send patients to our practice. So that we can continue to meet the needs of
our referring physicians and make improvements in our practice, please complete our
Referring
Physician Satisfaction Survey.
Our goal is to strengthen the relationship between our practice and yours, in an effort to
provide our patients with the highest quality comprehensive care in New England. Thank you
for your assistance and for your continued referrals!
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To Refer a Patient:
Please call our office at (617) 638-5633 to refer a patient. Please be prepared with the
following information when you contact us for a patient appointment:
Your contact information:
• Name
• Address
• Phone Number
• Fax Number
• E-mail
Information about your patient:
• Name
• Birth Date
• Address
• Phone Number
• Social Security Number
• Insurance Information
Your patient's medical history and records:
• Medical History
• Surgeries/Procedures
• Current Diagnosis
• How The Injury Occurred
• Current Medication Type/Dosage
• Allergies
Diagnostic tests as applicable:
• MRI: Actual film plus report
• Bone Scan: Actual film plus report
• CT Scan: Actual film plus report
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