Pediatricians and Health Care Providers at BMC, please use Epic form.

Pediatricians and Health Care Providers Outside BMC, please use the following form

- [**Download Referral Form**](/sites/default/files/Patient_Care/Specialty_Care/Pediatrics___Dentistry/Refer_a_Patient/field_Attachments/BPOHC-Referral-Form.pdf) **(PDF)**

For urgent Issues, please call the Same Day Clinic  
Phone: 617.414.ACHE (2243); Fax: 617.414.4866

To refer to the Friday Pediatric and Orthodontic Clinic at BUSDM:  
Phone: 617.638.4683; Fax: 617.638.5023

For special patient requests or to reach Dr. Zavras directly please call 617.638.4683 or email <zavras@bu.edu>.

For special patient requests or to reach Dr. Venegas directly please call 617.414.4837.