Mayo Clinic Alumni Association | Refer my own patient

Please have the following patient information available (when referring your own patient)

Patient’s given (legal) name; if female, maiden name (if available)
Birth date
Mailing address
Name of insurance provider and type of plan (HMO or PPO)
Whether the reason for referral is related to litigation, a motor vehicle accident, workers’ compensation or other liability
National Provider Identifier (NPI) or Unique Physician Identification Number (UPIN) of the referring physician
Diagnostic information (symptoms, tests performed and duration of patient’s medical concern)

Tips for referring a patient

Please keep the following in mind as you consider making a patient referral:

Patients with back pain must meet Mayo Clinic triage criteria for an appointment. This triage will occur during the phone call. If the patient does not meet Mayo Clinic triage criteria for an appointment, alumni may request to be connected to a Mayo Clinic physician for more information.
Patients with unsolvable, lingering chronic pain (longer than six months) are often not pleased with a referral to Mayo Clinic — or their referring physician — when no help can be offered.
Patients with chronic pain or those seeking a second opinion should be prepared ahead of time that there may be no further treatment options.

Patient Referrals