Heartland Primary Care - Patient Tools

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Patient Registration ( Patient Registration Form )
Use this form to register as a patient at Heartland Primary Care and grant consent for us to treat you.
Last updated: September 15, 2010, 11:05 PM
Downloaded so far: 1115 times.
Medical Records Release ( Medical Records Release )
Use this form to grant us permission to obtain/release your medical records.
Last updated: September 15, 2010, 11:53 PM
Downloaded so far: 1156 times.
X-Ray Release ( X-Ray Release )
Use this form to grant permission for us to release your x-rays for use outside of our medical practice.
Last updated: September 15, 2010, 11:07 PM
Downloaded so far: 1285 times.
HIPAA Privacy ( HIPAA Privacy )
Use this form to acknowledge your understanding of our privacy policies.
Last updated: September 15, 2010, 11:08 PM
Downloaded so far: 1465 times.
Medication Refills ( Medication Refills )
NOTE: You are able to conveniently use this website to request medication refills. But if you prefer to use the paper form, you may download it here.
Last updated: September 15, 2010, 11:10 PM
Downloaded so far: 1946 times.
  
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