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

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.