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Request an appointment (U.S. residents)

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Complete the form below to request an appointment at Mayo Clinic. An appointment representative will contact you within two business days to review your medical and financial information, including insurance coverage, before an appointment may be offered.

If you are having a medical emergency, call 911 or emergency medical help.

All fields are required unless marked optional.

Patient Information

Please provide patient information as it appears on legal documents.

The name of a parent is required if the patient is under the age of 18.


At which Mayo Clinic location(s) have you received care?

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Requester Information

Who are you requesting this appointment for?

Patient Insurance Information

Does the patient have health insurance?


Medical Concern

Response limited to 300 characters.
Response limited to 300 characters.
Response limited to 300 characters.

Is your request due to a:

Appointments by Phone

Calls may be monitored or recorded for quality purposes.

  • Mayo Clinic in Arizona
    800-446-2279 (toll-free)
    8 a.m. to 5 p.m. Mountain standard time, Monday through Friday
  • Mayo Clinic in Florida
    8 a.m. to 5 p.m. Eastern time, Monday through Friday
  • Mayo Clinic in Minnesota
    7 a.m. to 6 p.m. Central time, Monday through Friday

International patients: Please use the international appointment request form.

Referring physicians: Please use Mayo Clinic's referring physician services.