Financial Assistance Documents — Arizona campus

English versions

• Financial Assistance Application (PDF)
• Financial Assistance Policy (PDF)
• Plain Language Summary (PDF)
• Amount Generally Billed (PDF)
• Billing and Collection Policy (PDF)
• Outside Provider List (PDF)

Financial Assistance Application — Translated languages

• Financial Assistance Application — Arabic (PDF)
• Financial Assistance Application — Bosnian/Serbo-Croatian (PDF)
• Financial Assistance Application — French (PDF)
• Financial Assistance Application — German (PDF)
• Financial Assistance Application — Hindi (PDF)
• Financial Assistance Application — Italian (PDF)
• Financial Assistance Application — Japanese (PDF)
• Financial Assistance Application — Khmer (PDF)
• Financial Assistance Application — Korean (PDF)
• Financial Assistance Application — Mandarin Chinese (PDF)
• Financial Assistance Application — Navajo (PDF)
• Financial Assistance Application — Persian (PDF)
• Financial Assistance Application — Polish (PDF)
• Financial Assistance Application — Portuguese (PDF)
• Financial Assistance Application — Russian (PDF)
• Financial Assistance Application — Spanish (PDF)
• Financial Assistance Application — Tagalog (PDF)
• Financial Assistance Application — Thai (PDF)
• Financial Assistance Application — Vietnamese (PDF)

Financial Assistance Policy — Translated languages

• Financial Assistance Policy — Arabic (PDF)
• Financial Assistance Policy — Bosnian (PDF)
• Financial Assistance Policy — French (PDF)
• Financial Assistance Policy — German (PDF)
• Financial Assistance Policy — Hindi (PDF)
• Financial Assistance Policy — Italian (PDF)
• Financial Assistance Policy — Japanese (PDF)
• Financial Assistance Policy — Khmer (PDF)
• Financial Assistance Policy — Korean (PDF)
• Financial Assistance Policy — Mandarin Chinese (PDF)
• Financial Assistance Policy — Navajo (PDF)
• Financial Assistance Policy — Persian (PDF)
• Financial Assistance Policy — Polish (PDF)
• Financial Assistance Policy — Portuguese (PDF)
• Financial Assistance Policy — Russian (PDF)
• Financial Assistance Policy — Spanish (PDF)
• Financial Assistance Policy — Tagalog (PDF)
• Financial Assistance Policy — Thai (PDF)
• Financial Assistance Policy — Vietnamese (PDF)

Plain Language Summary — Translated languages

• Plain Language Summary — Arabic (PDF)
• Plain Language Summary — Bosnian (PDF)
• Plain Language Summary — French (PDF)
• Plain Language Summary — German (PDF)
• Plain Language Summary — Hindi (PDF)
• Plain Language Summary — Italian (PDF)
• Plain Language Summary — Japanese (PDF)
• Plain Language Summary — Khmer (PDF)
• Plain Language Summary — Korean (PDF)
• Plain Language Summary — Mandarin Chinese (PDF)
• Plain Language Summary — Navajo (PDF)
• Plain Language Summary — Persian (PDF)
• Plain Language Summary — Polish (PDF)
• Plain Language Summary — Portuguese (PDF)
• Plain Language Summary — Russian (PDF)
• Plain Language Summary — Spanish (PDF)
• Plain Language Summary — Tagalog (PDF)
• Plain Language Summary — Thai (PDF)
• Plain Language Summary — Vietnamese (PDF)

Amount Generally Billed — Translated languages

• Amount Generally Billed — Arabic (PDF)
• Amount Generally Billed — Bosnian (PDF)
• Amount Generally Billed — French (PDF)
• Amount Generally Billed — German (PDF)
• Amount Generally Billed — Hindi (PDF)
• Amount Generally Billed — Italian (PDF)
• Amount Generally Billed — Japanese (PDF)
• Amount Generally Billed — Khmer (PDF)
• Amount Generally Billed — Korean (PDF)
• Amount Generally Billed — Mandarin Chinese (PDF)
• Amount Generally Billed — Navajo (PDF)
• Amount Generally Billed — Persian (PDF)
• Amount Generally Billed — Polish (PDF)
• Amount Generally Billed — Portuguese (PDF)
• Amount Generally Billed — Russian (PDF)
• Amount Generally Billed — Spanish (PDF)
• Amount Generally Billed — Tagalog (PDF)
• Amount Generally Billed — Thai (PDF)
• Amount Generally Billed — Vietnamese (PDF)

Billing and Collection Policy — Translated languages

• Billing and Collection Policy — Arabic (PDF)
• Billing and Collection Policy — Bosnian (PDF)
• Billing and Collection Policy — French (PDF)
• Billing and Collection Policy — German (PDF)
• Billing and Collection Policy — Hindi (PDF)
• Billing and Collection Policy — Japanese (PDF)
• Billing and Collection Policy — Khmer (PDF)
• Billing and Collection Policy — Korean (PDF)
• Billing and Collection Policy — Mandarin Chinese (PDF)
• Billing and Collection Policy — Persian (PDF)
• Billing and Collection Policy — Polish (PDF)
• Billing and Collection Policy — Portuguese (PDF)
• Billing and Collection Policy — Russian (PDF)
• Billing and Collection Policy — Spanish (PDF)
• Billing and Collection Policy — Tagalog (PDF)
• Billing and Collection Policy — Thai (PDF)
• Billing and Collection Policy — Vietnamese (PDF)

Provider List — Translated languages

• Provider List — Arabic (PDF)
• Provider List — Bosnian (PDF)
• Provider List — French (PDF)
• Provider List — German (PDF)
• Provider List — Hindi (PDF)
• Provider List — Italian (PDF)
• Provider List — Japanese (PDF)
• Provider List — Khmer (PDF)
• Provider List — Korean (PDF)
• Provider List — Mandarin Chinese (PDF)
• Provider List — Navajo (PDF)
• Provider List — Persian (PDF)
• Provider List — Polish (PDF)
• Provider List — Portuguese (PDF)
• Provider List — Russian (PDF)
• Provider List — Spanish (PDF)
• Provider List — Tagalog (PDF)
• Provider List — Thai (PDF)
• Provider List — Vietnamese (PDF)

Patient resources

If you have questions regarding your Mayo Clinic monthly statement or financial assistance, please call Patient Account Services at 844-217-9591 (toll-free) or 504-266-0909 (international patients). The TDD line is 602-301-7683.