Due to the complexity of the referral process within each insurance company, please allow 10 business days to complete each referral.

Merrimack Family Medicine is affiliated with Lowell General Hospital.  All referrals and specialists appointments will be confirmed with providers within our network.  All visits must be pre-approved by your PCP.  Any visits with specialists not within our network may not be allowed and the cost of that appointment will be your financial responsibility.

Not sure if your specialist is allowed?  Call the office BEFORE you schedule an appointment.

Call Merrimack Family Medicine (978-851-4141 ext. 2) to request the referral. You will need to provide:

  • Patient’s Name
  • Date of Birth
  • Insurance
  • Specialist Name
  • Specialist NPI # – National Provider Identification Number
  • Specialist Telephone Number & Fax Number
  • Reason for Your Visit
  • Date of Your Visit

Last minute requests may affect your financial responsibility for that appointment.

As a reminder, patients can request referrals online through our Patient Portal.

ECW Patient Portal – Contact your Primary Care Physician online.