800 533 1564-2026

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The document is a referral form for patients to be submitted to the Mayo Clinic, providing contact information for various locations, sections for referring physician and patient details, and a request for appointment information including symptoms and specialty needed.

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Click ‘Get Form’ to open the document in the editor.
Begin by filling out the 'Referring Physician Information' section. Enter the referring physician’s name, date, office address, NPI number, city, state, ZIP code, and phone number.
Next, complete the 'Patient Information' section. Input the patient's Mayo Clinic number, social security number (for informational purposes only), full name, address, county (optional), home phone number, sex (select either male or female), alternate phone number (mobile or work), maiden name (optional), and birth date.
Indicate if the patient requires an interpreter by selecting 'Yes' or 'No.' If yes, specify the language needed.
In the 'Appointment Request' section, provide a detailed reason for referral along with any pertinent medical records and insurance card if available. Specify the specialty requested.
Once all fields are completed accurately, review your entries for correctness before submitting.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Is it hard to become a patient at Mayo Clinic?

And youll hear often that, Mayo Clinic receives more appointment requests than they can grant, so unfortunately they cant fulfill all requests. There are many stories here, one person wrote theyd walk on broken glass to get established at Mayo (and did), and many others who were not so lucky.

How to get a second opinion from Mayo Clinic?

You can self-refer for a second opinion or ask your oncologist for a referral to Mayo Clinic. You can start this process from our website. Most questions about how to self-refer are answered in these Frequently Asked Questions.

How do I contact Mayo Clinic in Rochester?

Mayo Clinic, Rochester, Minnesota Phone: 800-533-1564 (toll-free) Fax: 800-321-1368 (toll-free) From outside the U.S.: 507-538-1515 (phone) or 507-538-7802 (fax)

What is the phone number for Mayo Clinic referral?

You can call us at 1-855-392-8400 to confirm necessary information for the referral, and route your request and records to the appropriate department for review.

What is the phone number for Mayo Clinic Research?

Phone: 855-776-0015 (toll-free). This number is answered from 7 a.m. to 6 p.m. CST, Monday through Friday.

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Is Mayo Clinic the best hospital in the world?

Specialties A. Addiction Treatment (Substance Abuse) Care for people with alcohol and other drug addictions. B. Bariatric Surgery (Weight-loss Surgery) C. Cardiac Rehabilitation. D. Dermatology. E. Emergency Medicine (Trauma) F. Family Medicine. G. Gastroenterology Hepatology (Digestive Care) H. Hematology (Blood)

800 533 1564-2026

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How to use or fill out 800 533 1564 with our platform

Complete this form in 5 minutes or less

Got questions?

Is it hard to become a patient at Mayo Clinic?

How to get a second opinion from Mayo Clinic?

How do I contact Mayo Clinic in Rochester?

What is the phone number for Mayo Clinic referral?

What is the phone number for Mayo Clinic Research?

Security and compliance

Complete this form in 5 minutes or less

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Is Mayo Clinic the best hospital in the world?

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