Registration Forms

New patients are encouraged to download and complete the following forms prior to their first visit. These forms may be opened and printed through Adobe Acrobat Reader. If you do not have Acrobat Reader, you may download it free by following this link.

Optimal Form - required for all new patients

Summary List - required for all new patients

Outpatient Manual Registration Form - this form is only required if you have not been preregistered through St. John's Mercy. Please call the Pre-Registration Department at 314-364-4646.  If you preregister, this form does not need to be completed.

In addition to these completed forms, please bring your insurance card and prescription for therapy to your first visit.  Please arrive prior to your scheduled appointment time.  If you do have a need to cancel an appointment, please call us as soon as possible so that we may reschedule your visit.

© 2008 St. John's Mercy Health Care
615 S. New Ballas Rd., St. Louis, Missouri, 63141