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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

Notice of HIPAA Privacy Practices

Acknowledgement of Receipt - HIPAA Privacy Practices

Release of Records Forms

Our Locations

Proudly Serving The Surrounding St. Louis Area

Hours Of Operation

Call Us Today To Book Your Appointment!

Chesterfield Location

Monday:

9:30 am-7:00 pm

Tuesday:

9:30 am-7:00 pm

Wednesday:

9:30 am-7:00 pm

Thursday:

9:30 am-7:00 pm

Friday:

9:30 am-6:00 pm

Saturday:

9:00 am-12:00 pm

Sunday:

Closed

St. Peters Location

Monday:

9:30 am-7:00 pm

Tuesday:

9:30 am-7:00 pm

Wednesday:

9:30 am-7:00 pm

Thursday:

9:30 am-7:00 pm

Friday:

9:30 am-6:00 pm

Saturday:

9:00 am-12:00 pm

Sunday:

Closed