Request an Appointment

Please complete the form below to request an appointment with an SIU Medicine provider. An SIU Medicine representative will contact you to review your submitted information and help you create an appointment. If you prefer to call us to schedule an appointment, call 217-545-8000, Monday-Friday, 8 a.m. to 4:30 p.m. If you have a medical emergency, please call 911.

Appointment Details

Patient Information

Insurance information is required so that we can best match doctors' accepted insurance plans with patients' plans.

Optional Information