Phone: 502-384-7293 Fax: 843-380-4199 9700 Park Plaza Avenue | Suite 101 | Louisville, KY 40241

MedLou Waitlist

The Physicians at MedLou are not currently accepting new patients. Please complete the form below to be added to our waiting list.

Patient's Name

First Name

Last Name

Patient's Date of Birth

I am not on Medicaid

By law MedLou is not allowed to accept Medicaid patients. By checking the box below, I agree that I am not on Medicaid.

I agree

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Email