If you do not read/speak English, please call 855-776-0015 (toll-free) for interpreter services.
If you aren't the patient, please answer the questions below and then complete the patient information for the patient. If you are the patient, please skip this section and complete only the patient information section.
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:
Important: After submission, please do not leave this form until you see the confirmation message.