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Make your appointment or second opinion with Dana-Farber today to meet with an onsite specialist.

Adult Patients:877-442-3324

Pediatric Patients:888-733-4662

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Can’t get to Boston? Explore our Online Second Opinion service to get expert advice from Dana-Farber oncologists.

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By phone

To refer an adult patient, call 877-441-3324.
To refer a pediatric patient, call 888-733-4662.

Online

Please fill out and submit this form. A New Patient Coordinator will contact your office within four hours, excluding weekends and holidays. Our regular business hours are 9:00 a.m. – 5:00 p.m. ET.

Items in BOLD are required.

Patient Information
First Name:
Middle Name or Initial:
Last Name:
Date of Birth:Month:     Day:     Year: 
   
Gender:
Diagnosis Information
Diagnosis:
If other, please specify:
Additional Clinical Information (i.e. test results, etc.):
Physician Information
Name:
Contact Name:
Address:

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Fax:
E-Mail:
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Additional Information
Physician Referred to (if applicable):
Patient Phone:
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We take privacy very seriously and make every effort to maintain your full confidentiality. Before using this form you should be aware of our Privacy Policy.

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Boston, MA 02215

Call us toll-free: 866-408-DFCI (3324)

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Dana-Farber/Brigham and Women’s Cancer Center is ranked #4 nationally and the best in New England.

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Dana-Farber/Boston Children's is ranked the #1 pediatric cancer center.

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