Pentucket Medical Center

Physician Referrals

If you require a referral from your primary care physician to see a specialist, you may either fill out the online referral form or call our office directly.

 

 Regular office hours are
Monday through Friday 8:30 a.m. to 5:00 p.m.
Haverhill, Newburyport, & RiverWalk Offices: 1-888-227-3762
Georgetown Office (978) 352-8375
Methuen Office: (978) 738-8050

ONLINE REFERRAL FORM - Please fill out ALL fields.

Specialist Name
Specialist Location
Your Name
Birth Date (Month) (Day) (Year)
Primary Care Physician
Reason for Referral
Appointment Date (Month) (Day)
Your Email
Re-type Email
Primary Phone
Secondary Phone
 

NOTE: You may want to print this page for your records before submitting the form.