Requests that meet the criteria outlined on the Eligibility and Guidelines sections may use the form below. The following information is required to complete the request process.
All fields are required unless marked optional.
Important: After submission, please do not leave this form 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: