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Core Facilities Services Request Form

Core Facilities Services Request Form

Note: This form is intended for researchers seeking the services of a Mayo Clinic core laboratory. Patient inquiries should be directed to the Mayo Clinic appointment request page. Please do not share any type of patient information.

Complete the form to request core research services. All fields are required.

Your information
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Provide a number where you can be reached between 8 a.m. and 5 p.m. Central time, Monday through Friday.
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Your needs
Indicate which area best describes your needs (select all that apply):


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Core facility services
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After submitting your request, do not leave this form until you see the confirmation message.

Mayo Clinic Number

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:

In correspondence:

Image of Form: Authorization for Mayo Clinic to Disclose Protected Health Information

In pre-appointment questionnaires

Image of Form: Authorization for Mayo Clinic to Disclose Protected Health Information

In medical documents:

Image of Form: Authorization for Mayo Clinic to Disclose Protected Health Information

In dismissal summaries:

Image of Form: Authorization for Mayo Clinic to Disclose Protected Health Information

In several other kinds of documents:

Image of Form: Authorization for Mayo Clinic to Disclose Protected Health Information
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