Patient Referrals

Mayo Clinic is committed to responding to all alumni patient referrals in an efficient, timely manner. Please identify yourself as an alumnus or alumna when referring a patient. This will ensure that your request receives priority attention.

Refer someone who is not your patient

If you are a Mayo Clinic alumnus or alumna and would like to refer someone who is NOT your patient, please fill out the form below.

Note that the person you are referring must be aware that you are making the referral so that patient scheduling representatives can contact the prospective patient.

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Your Information

Patient Information (all required)

Disclaimer: This form not intended for HIPAA protected information.

Prefer to refer someone over the phone? Call any of our locations to get started.

  • Rochester, Minnesota 800-533-1564 (toll-free) 507-266-5770
  • Phoenix/Scottsdale, Arizona 866-629-6362 (toll-free) 480-301-6539
  • Jacksonville, Florida 800-634-1417 (toll-free) 904-953-2934

Important Information

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.

How are we doing?

We always are looking for feedback about the patient referral process. If there is anything you would like to share with us about how we can make this experience better, please contact the Mayo Clinic Alumni Association office at