Request an Appointment
To ensure a smooth and expedited intake process:
Please obtain a medical record number (MRN) by calling Mass General registration at 866-211-6588, Monday-Friday, 8:00am to 5:00 pm ET.
Please be sure to request that your pulmonologist or primary care provider submit the following required documents via fax: 617-726-2581.
- Recent pulmonologist notes
- Recent pulmonary function tests
- Chest CT reports
- Echocardiogram results
- Labs, including chemistry and hematology
- Demographic and Insurance information
Please use this form only if:
- You have never been a patient in the Lung Transplant Program
Important note: Some questions on this form may appear or disappear based on your responses.
* indicates a required field.
About Your First Appointment
Your first appointment with the Lung Transplant Program will be a comprehensive pre-transplant evaluation that includes a medical consultation, laboratory tests and specialized procedures to determine if you may be a candidate for transplantation. Before we can schedule your pre-transplant evaluation, you will need to do the following:
- Submit the secure form above
- Obtain a Mass General Medical Record Number (MRN) — If you have not received care at Mass General in the last six months, or if you have never received care at Mass General, please call 1-866-211-6588 (toll free) to verify your information and/or obtain an MRN
After you submit the form, a lung transplant nurse coordinator and a transplant pulmonologist will review your information and call you back with the information you’ll need to make an appointment. You may also speak with a representative directly Monday–Friday, 8:00 am to 4:00 pm EST by calling 800-876-5864.