Executive Health Program

Individual Registration Forms for Mayo Clinic in Arizona

After printing and completing the appropriate registration forms, attach a copy of the back and front of your insurance card(s) to the form and fax it to Mayo Clinic within 48 hours of contacting us to help us expedite your schedule in a short time frame. Mayo Clinic cannot accept forms via email.

The forms below can be opened with Adobe Acrobat Reader.

1. Information for your doctor
2. Executive Health Program registration
3. Patient information Mayo Clinic authorization
4. 2012 standard protocol & optional services
5. Fees and insurance
6. Hotel accommodations
7. General information
8. Return fax cover sheet
9. Notice of privacy practices
10. Authorization to disclose protected health information