Patient Portal Registration

The Ste. Genevieve County Memorial Hospital and Physician Clinics' Patient Portal provides you with online access to your medical record. You can use the portal to view and request appointments, send messages to your provider and update your medical information (conditions, allergies, immunizations, etc.).

With the consent of the patient, you can view other adult's medical records, such as your spouse or parents. Parents can also view medical records for their children under the age of 13 (in accordance with Missouri law).

ALL FIELDS must be filled in for your information to be processed. Thank you.

Please check to make sure ALL FIELDS are filled in. By submitting this form you are electronically signing enrollment request. Thank you.

Name

Address*

(Address is required)

Phone Number * (Phone Number is required)

Last 4 Digits of Social Security Number * (Last 4 Digits of Social Security Number is required)

Date of Birth

E-mail Address

Would you like to be on our mailing list?

Yes

Signature (by typing your name, you agree to sign up for the Patient Portal)

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Patient Portal Registration

Physician Search