New Provider Profile Form
Welcome to SIU Medicine!
Please fill out this form to provide the marketing team information for your online profile.
These profiles will be display on one or both of our websites; www.siumed.org (patient audience) and www.siumed.edu (student audience). Therefore, it is important you fill this out as detailed as possible to provide your information and specialties to the correct audience. We will filter information based on the audience.
Please reach out to us with any questions.