You may request a referral from one of our physicians by one of the following methods.

Click here to view and print out the referral form.

It is important to remember that we require the following information to process your referral:

  • Your child's full name and date of birth
  • Your name and daytime contact telephone number
  • Your child's doctor
  • Insurance carrier and ID number
  • Full name, address, phone number and specialty of the specialist
  • Reason for the visit
  •  Date of the appointment


1.  Email through the Framingham Pediatrics Patient Portal (click here) 

  • Log in to your child's individual Patient Portal account and send a secure email to the office.
  • These messages are reviewed frequently throughout the day.
  • If you do not have a Patient Portal account, please call the office and ask one of our staff to set you up with a username and password.


2.  Call the Referral Telephone Line:  (508) 879-1226


  • Simply leave a recorded message for our office staff requesting the referral.
  • Messages will be checked twice a day during the week.

3.  Fax the above information to (508) 820-0864

  • Faxes are checked frequently throughout the weekday.