Patient Forms

If you are interested in becoming a new patient within our Logan University Health Centers, please use the forms below, provided for your convenience. The Notice of HIPAA Privacy Practices form is for you to keep.

New Patient Form

New Patient Health Questionnaire

Radiology Informed Consent Form

Notice of HIPAA Privacy Practices

Acknowledgement of Receipt - HIPAA Privacy Practices

Authorization to use and/or disclose health information Form

Our Locations

Proudly Serving The Greater St. Louis Area


1851 Schoettler Rd, Chesterfield, MO 63017, USA



6131 Mid Rivers Mall Drive St. Peters, MO 63304

Hours Of Operation

Call Us Today To Book Your Appointment!

Chesterfield Location

Monday:

9:00 am-6:00 pm

Tuesday:

9:00 am-6:00 pm

Wednesday:

9:00 am-6:00 pm

Thursday:

9:00 am-6:00 pm

Friday:

9:00 am-6:00 pm

Saturday:

9:00 am-12:00 pm

Sunday:

Closed

St. Peters Location

Monday:

10:00 am-5:00 pm

Tuesday:

10:00 am-5:00 pm

Wednesday:

10:00 am-5:00 pm

Thursday:

10:00 am-5:00 pm

Friday:

10:00 am-5:00 pm

Saturday:

Closed

Sunday:

Closed

Contact Us Today!

We look forward to hearing from you.