Please click on the link below to open our Secure Online Forms.  After completion, click the Submit button to send it securely to our office.

New Patient Form package

Medical Records Transfer Request - from our office

Medical Records Transfer Request - to our office

Please click on each link below to download an Adobe Reader® file of that form. Bring the applicable forms with you to your first visit along with your insurance card, medication list, and driver’s license or other photo I.D.

PDF Icon54x54Notice of Privacy Practices (information only)

If you don’t have a copy of Adobe Reader on your computer, please click here for a free download.get adobe reader

If you are experiencing a life threatening situation: Call 9-1-1

​If you are not experiencing a life threatening event, but want to contact us about a medical issue, please contact our office by phone during regular business hours.

Heartland Podiatry, PC
2406 South R.D. Mize Rd.  •  Independence, MO 64057  •  816-478-3338
1161 SE Oldham Parkway  •  Lee’s Summit, MO 64081  •  816-478-3338

CreditCards