@sandmason I had long distance ACDF surgery at Mayo in Rochester. It was a 5 hour drive for us. I chose to come back to see my surgeon for follow up, but he would have let me followup remotely from home. I came back for a 6 week followup and Xrays were taken by Mayo, but they could have mailed orders for them to be done near my home and I could have seen my primary care physician. At my 6 month followup, I did do X rays at home and mail them to my surgeon at Mayo. For scheduling, the surgeon's nurse does that, and does it all at once for a group of patients. I returned home after the first appointment, waited for a blood test result, then maybe a week after that, she was scheduling. I could have had surgery in 2 weeks at that point because an ACDF doesn't take as much time as a bigger spine surgery and can fit more easily into the doctor's schedule and be scheduled a little sooner. My surgeon would do 2 ACDF surgeries per day or one bigger spine surgery. They can have a cancellation for insurance issues or illness that might open up a surgery slot sooner, and surgeons travel to conferences too which delays their patient schedule. I stayed a few days in the hotel after surgery to make sure there were no complications, and returned home 3 days later by car. I was in a neck brace and you feel every bump in the road, and have to hold your head getting in and out of the car because any bending over will hurt, and you'll be very tired, but you have to get out and walk every few hours to avoid risk of blot clots after surgery. That risk is something they worry about for a month after surgery. A patient won't be able to drive or lift much weight. My restriction was 10 pounds max for the first 6 weeks. My surgery was about 6 weeks after my first appointment, but could have been done in 3 weeks, but I wasn't ready with my home organization that I knew I could not do after surgery. I think traveling 1200 miles driving would be OK if it's broken into easier chunks, maybe 3 days. After surgery, the patient just wants to sleep and would have to be supported well in the car for that (there is likely a hard neck brace, mine was a Miami J). You can contact your surgeon on the patient portal, and the nurse would respond. I'm presuming from your question that you are going for the evaluation first and need to get an offer for surgery first, and wondering how it proceeds from there? Mayo's evaluation is thorough, and they look at other issues you may have. You have to have a primary care physician clear you for surgery, but not older than a month to be valid, and the insurance companies have to review it to determine if they will cover surgery, and usually wait until the last days to accept it, so you're scheduled and wondering if it will get canceled by insurance. My insurance sent an approval about a week before my procedure. I wouldn't expect that you could do this all in one trip, and you might have options to think over. I could have had an ACDF or disc replacement (not the best choice in my case), but I had the choice. Let me know if this answers your questions. I think you have to get through that first appointment before your timetable comes into view. then at that point, the follow up are likely, 6 weeks, 6 months, and a year later. I had no hardware, just a neck brace that I wore for 4 months until fusion began per my agreement with my surgeon.