All fields are optional.
As you think about the questions below and provide answers and feedback, focus on the bulleted "Call to Action" section in the full report.
Institutional buy-in: As you think about the questions below, focus on and provide information for your institution.
After submitting the form, do not leave this page until you see the confirmation message.
Your Mayo Clinic number is a 7, 8 or 9-digit number we assign to you as a new patient prior to your first visit. You can find it near the top of a range of documents, including pre-visit questionnaires, clinical notes, care summaries, and correspondence.
If you do have Mayo paperwork handy, it's often quickest simply to look for it there. Scroll down to see some examples of how the number shows up: