Forms

By May 1, 2012, complete and return these forms as indicated.

Form	Instructions	Deadline
Official Signature for Medical Records	Sign and return to Julie H. Griffis.	May 1
Authorization to Release Information by Mayo School of Graduate Medical Education	Complete and return to Julie H. Griffis.	May 1
Record of U.S. Entry and Departure	Complete and return to Julie H. Griffis. If applicable, attach the documents noted near the end of the form.	May 1
Resident Physician Membership Application	Complete and return to Julie H. Griffis. Do not attach a check or include credit card information, as Mayo Clinic will pay for your membership.	May 1
Vehicle Parking Decal(s) Request	Complete and return to Julie H. Griffis. Use your current license plate number, even if it's from outside Florida.	May 1

Mail or hand deliver completed forms and documents to:

Mayo Clinic in Florida
Attn: Julie H. Griffis
Davis Building, Room 172W
4500 San Pablo Road
Jacksonville, FL 32224

If you have questions about these forms, contact Julie H. Griffis at 904-953-0429 or griffis.julie@mayo.edu.