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

Name:

Email:

Phone number:

Provide a number where you can be reached between 8 a.m. and 5 p.m. Central time, Monday through Friday.

If necessary, please specify time(s) you prefer:

Name of your organization or research entity:

Your needs

Indicate which area best describes your needs (select all that apply):

Technical support
Sample processing and/or testing
Data analysis

Core facility services

Which service line would best meet your needs?

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

Core Facilities Services Request Form

Core Facilities Services Request Form

Mayo Clinic Number

In correspondence:

In pre-appointment questionnaires

In medical documents:

In dismissal summaries:

In several other kinds of documents:

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