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    Executive Health
    Next Steps

    Your Health is Important.
    Take the Next Step Today.

    Over 20,000 qualified patients each year rely on Mayo Clinic’s Executive Health Program to protect and optimize their health and performance. Learn why so many business leaders choose and make time to travel to Mayo Clinic for Executive Health.

    For Individual Executives

    Learn more about Executive Health

    We are happy to provide additional program details – services, tests, costs, insurance coverage, and more.

    Learn More

    Ready to Apply?

    We invite you to apply to become part of our category-of-one Executive Health Program and make your first appointment.

    Apply Today
    For Companies and Business Leadership Teams

    Corporate Leadership Team Enrollment

    More than 1,400 companies offer Mayo Clinic’s Executive Health Program as an executive-level benefit to their leadership. We’re happy to discuss options for bringing the program to your organization.

    Connect Today
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    Individual Inquiry

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    Tell us about yourself

    Please complete this Inquiry Form to receive more information about the Mayo Clinic Executive Health Program.  We will send our program information to the e-mail address that you provide in the form below.  Your responses on this form will NOT be used for qualification purposes.

     

    Preferred Location

    Which Mayo Clinic location are you interested in?

    Which Mayo Clinic location are you interested in?

    Select all locations that apply.

    Personal Information

    Legal First Name

    Legal First Name

    Legal Last Name

    Legal Last Name

    Date of Birth

    Date of Birth
    • Female
    • Male
    • Nonbinary
    • Unknown

    Email

    Email

    Phone Number

    Phone Number
    Is your Primary Address located in the United States?

    Is your Primary Address located in the United States?

    Zip Code of Primary Address

    Zip Code of Primary Address

    Country of Primary Address

    Country of Primary Address

    Company Information

    • Full-time (30+ hours per week)
    • Part-time (less than 30 hours per week)
    • Retired
    • Other

    Current Position Title

    Current Position Title

    Name of Current Employer

    Name of Current Employer

    Current Position Title

    Current Position Title

    Name of Current Employer

    Name of Current Employer

    Current Position Title

    Current Position Title

    Name of Current Employer

    Name of Current Employer

    Current Position Title

    Current Position Title

    Name of Current Employer

    Name of Current Employer

    Describe Your Current Employment

    Describe Your Current Employment

    Current Position Title

    Current Position Title

    Name of Current Employer

    Name of Current Employer
    Executive Health Logo

    Corporate Inquiry

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    Corporate Inquiry Form

    Our Corporate Enrollment option is intended for organizations with minimum of 25 total employees and/or $5M in annual revenue. To enroll, the company must complete a separate corporate enrollment form and agree to cover some or all costs for its C-suite or leadership team.

    Individual executives should use the Individual Inquiry Form, not the Corporate Inquiry Form.

    Preferred locations

    Mayo Clinic Location of Interest

    Mayo Clinic Location of Interest

    Select all locations that apply.

    • Google search
    • Social media
    • Friend or colleague recommendation

    Tell us about yourself

    Personal Information

    Legal First Name

    Legal First Name

    Legal Last Name

    Legal Last Name

    Email

    Email

    Phone Number

    Phone Number

    Location Information

    City

    City

    State/Province/Region (County if UK)

    State/Province/Region (County if UK)

    Country

    Country

    Tell us about your company

    Company Information

    Name of Current Employer

    Name of Current Employer

    Current Position Title

    Current Position Title
    • Less than 25
    • 25 - 100
    • 100 - 1,000
    • More than 1,000

    Company Website (Optional)

    Company Website (Optional)
    • Full-time (30+ hours per week)
    • Part-time (less than 30 hours per week)
    • Retired
    • Not Employed
    • Other

    Add comments here

    Do you have any specific questions or comments about the Executive Health Program?

    Add comments here0/300
    Executive Health Logo

    Application Submission

    Apply to participate in the Mayo Clinic Executive Health Program

    I understand that this program is designed specifically for working executives, business leaders, and other qualified individuals - that qualification criteria considered can include work status, company information, business title, and other related information - and that should I qualify additional information will be required to register as a Mayo Clinic patient.

    Want to learn more? Before applying complete our Individual Inquiry Form and we’ll send you all the details. If you’re ready to apply, please complete the below form.

    Corporate Applications

    If you represent a business leadership team and want to apply on behalf of your employees, please fill out the contact form at the link below. Our Executive Health staff will reach out as soon as possible.

    Preferred locations

    Mayo Clinic Location of Interest

    Mayo Clinic Location of Interest

    Select all locations that apply.

    • Google search
    • Social media
    • Friend or colleague recommendation

    Tell us about yourself

    Personal Information

    Legal First Name

    Legal First Name

    Legal Last Name

    Legal Last Name

    Date of Birth

    Date of Birth
    • Female
    • Male
    • Nonbinary
    • Unknown

    Email

    Email

    Phone Number

    Phone Number

    Mailing Information

    Primary Mailing Address

    Primary Mailing Address

    Address Line 2 (Optional)

    Address Line 2 (Optional)

    City

    City

    State/Province/Region (County if UK)

    State/Province/Region (County if UK)

    Country

    Country

    Zip Code/Postal Code

    Zip Code/Postal Code

    Tell us about your company

    Company Information

    • Full-time (30+ hours per week)
    • Part-time (less than 30 hours per week)
    • Retired
    • Other

    Name of Current Employer

    Name of Current Employer

    Current Position Title

    Current Position Title
    • Less than 25
    • 25 - 100
    • 100 - 1,000
    • More than 1,000

    Company Website (Optional)

    Company Website (Optional)
    Do you have any other business or membership affiliations we should be aware of for qualification purposes? (Optional)

    Add comments here

    Add comments here

    Additional details

    Medical Information

    Do you have a primary care provider for your day-to-day healthcare needs?

    Do you have a primary care provider for your day-to-day healthcare needs?

    Having an established primary care provider is a requirement for participating in the Executive Health Program.

    Primary Care Provider Name

    Please provide the primary care provider’s name and address.

    Primary Care Provider Name

    Primary Care Provider Address

    Primary Care Provider Address
    Do you have health insurance?

    Do you have health insurance?

    Insurance Carrier & Policy/Plan Name

    Insurance Carrier & Policy/Plan Name

    Insurance Carrier Mailing Address

    Insurance Carrier Mailing Address

    Subscriber Name

    Subscriber Name

    Subscriber Birth Date

    Subscriber Birth Date

    Member/Subscriber ID Number

    Member/Subscriber ID Number

    Group Number

    Group Number
    If you are invited to join the Executive Health program, do you agree to be self-pay which may require a pre-service deposit before receiving services?

    If you are invited to join the Executive Health program, do you agree to be self-pay which may require a pre-service deposit before receiving services?

    Are you a current or previous patient at Mayo Clinic?

    Are you a current or previous patient at Mayo Clinic?

    Miscellaneous

    If you are accepted as qualified for the Mayo Clinic Executive Health program, what timeframe would you prefer for your first visit?

    If you are accepted as qualified for the Mayo Clinic Executive Health program, what timeframe would you prefer for your first visit?

    Please note: clinical calendars may be full for the next 3 months.

    • January
    • February
    • March
    • April
    • May
    • June
    • July
    • August
    • September
    • October
    • November
    • December
    • 2026
    • 2027
    • 2028
    Has your spouse or partner been accepted as qualified for the 
Mayo Clinic Executive Health program, or are they currently applying to join?

    Has your spouse or partner been accepted as qualified for the 
Mayo Clinic Executive Health program, or are they currently applying to join?

    Spouse/Partner’s Name

    Spouse/Partner’s Name

    Spouse/Partner’s Date of Birth

    Spouse/Partner’s Date of Birth

    Spouse/Partner’s Mayo Clinic Number (Optional)

    Spouse/Partner’s Mayo Clinic Number (Optional)