Please complete, print and submit. Reset Form Referral to Mayo Clinic Fax to the desired location: Rochester, MN Domestic Phone 800-533-1564 Fax 800-321-1388 International Phone 507-284-8884 Fax 507-538-7802.

How it works
  • Open form

    Open form follow the instructions

  • Easily sign form

    Easily sign the form with your finger

  • Share form

    Send filled & signed form or save

How to fill out the 800 533 1564 online

Completing the 800 533 1564 form online is a straightforward process that requires careful attention to detail. This guide aims to assist users in effectively filling out the form while ensuring all necessary information is accurately provided.

Follow the steps to successfully complete the form.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by entering the referring physician information. This includes the referring physician's name, date, office address, NPI number, city, state, ZIP code, and phone number.
  3. In the patient information section, provide the patient's Mayo Clinic number, social security number (for informational purposes only), full name (first, middle initial, last), address, county (optional), city, home phone, sex (male or female), alternate phone (mobile or work), maiden name (optional), and birth date.
  4. If the patient is a minor, include the parent’s name. If necessary, indicate whether the patient needs an interpreter and specify the language.
  5. In the appointment request section, clearly state the reason for referral, any symptoms or diagnosis, and submit any pertinent medical records and the patient’s insurance card if available. Specify the specialty requested.
  6. After reviewing all entries for accuracy, users can save changes, download, print, or share the form to ensure it is submitted correctly.

Take the next step and fill out the 800 533 1564 form online today!

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Related content

History of Changes for Study: NCT00964379...

[Recruiting] Rochester, Minnesota, United States, 55905. Contact: Bruce Wolff, MD...

Learn more
Patient Referrals - Mayo Clinic Alumni Association

800-533-1564 (toll-free) 507-266-5770. Mayo Clinic in Phoenix/Scottsdale, Ariz...

Learn more
Vintage Cutler-Hammer panelboards and switchboards...

600. 63.00 (1600.2). 63.00 (1600.2). 99-3613-10. 30. 800. —. 59.00 (1498.6). © ... PH-L...

Learn more
Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

How does a referral to Mayo Clinic work?

If your local provider refers you to Mayo Clinic, he or she will likely submit your medical records for you. If you're visiting without a referral, ask your provider to share your records. If additional files are needed once you arrive, Mayo will contact your provider.

U.S. News & World Report Best Hospitals Rankings 1 hospital in the nation, ing to U.S. News & World Report's 2022-23 "Best Hospitals Honor Roll." Mayo Clinic ranked No. 1 in Minnesota, Arizona and Florida. Mayo Clinic in Rochester is the No.

Mayo Clinic is nationally ranked in the top 5 in Cancer, Cardiology & Heart Surgery, Diabetes & Endocrinology, Gastroenterology & GI Surgery, Geriatrics, Obstetrics & Gynecology, Orthopedics, Pulmonology & Lung Surgery, Rheumatology and Urology.

Mayo Clinic is consistently ranked in the U.S. News & World Report rankings of top hospitals. Mayo Clinic is regularly acknowledged among the very best in the nation in the following specialties: Cancer. Cardiology and heart surgery.

Scheduling appointments and contact information To reach the Arizona scheduling office, please call 480-301-8484 between the hours of 8 a.m. and 5 p.m. Mountain time, Monday through Friday, or contact us online. A telephone or video appointment may be available to meet your care needs.

You also can seek out a second opinion on your own. This is your choice, so don't feel bad about looking for additional support in feeling confident about your care.

Mayo Clinic experts solve the world's toughest medical problems — one patient at a time. No matter what serious, complex or rare health challenge you're facing, you can be confident that Mayo Clinic has extensive experience in treating patients with your specific condition.

Mayo Clinic appointment scheduling is determined in part on the basis of need, with more severe medical conditions taking priority. If your condition is not serious, is general in nature, or can easily be handled by physicians at another facility, you may have to wait quite a while to be seen.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

If you believe that this page should be taken down, please follow our DMCA take down process here.

Get 800 533 1564