Important Information Regarding the St. John’s Mercy Appointment Request Form

So that we can schedule an appointment for you with an appropriate physician, you will need to provide us with confidential health information. St. John’s Mercy is committed to maintaining its patients' privacy. We will use the information you provide only to help us respond to your query.

We have put in place appropriate physical, electronic and administrative procedures to safeguard and secure the information we collect from you. The information you transmit in your appointment request will be encrypted during transmission to St. John’s Mercy. However, please note that normal e-mail is not encrypted. If you have indicated that you would like to receive a response from us via e-mail, you are authorizing us to respond to you with an unencrypted e-mail message that may contain private information. If you are uncomfortable submitting this information electronically or receiving a response from us via e-mail, please call us at 314-367-3627 or 1-888-700-7171 Monday through Friday, 8 a.m. to 4:30 p.m. One of our referral nurses will be happy to assist you.