Patient Portal & Forms
PATIENT PORTAL IS FOR NON-URGENT COMMUNICATION ONLY, EXPECT MESSAGE REPLIES IN 3-5 BUSINESS DAYS.
- Create a unique Username and Password
- Enter your first and last name
- Enter ZIP Code and DATE OF BIRTH (MM/DD/YYYY)
- Enter Your security code – this is a unique security code which must be provided by the office prior to registration. Don’t have your security code? Feel free to call and inquire.
- Check the Terms and Conditions Checkbox
- Click Create Account
Please note that your First Name, Last Name, Zip Code and Date of Birth must match the information provided to the practice when you scheduled your appointment.
Select three security questions and answer them. Click Continue
Once logged in, navigate to your upcoming appointments. Next to your appointment will be a blue button “Update Information” that will direct you to paperwork that needs to be completed prior to that appointment. Click on the link and follow the below steps:
- Update your demographics information
- Skip through the insurance section
- Finish and/or update online medical history forms
- Don’t see your medical record? Click on the link “Don’t see the practice you’re looking for?” and enter our unique practice ID: YYIZAY
- Double check your first name. What name did you give the office when you called? Is there a nickname you go by that differs from your formal name?
- Security Code? Every patient has a unique security code that we will provide for you. Call our office at (888) 515-2847 and we’ll be happy to assist.
- Still need assistance? Call (888) 515-2847 to speak with a front office staff member.
Issues with registering through the patient portal for your paperwork? Prior to attending your consultation with Heartland Plastic & Hand Surgery, please print and complete the below forms and bring them to your appointment:
- Patient Medical History Form
- Patient Demographic Information
- HIPAA Right of Access Form for Family Member/Friend
- Consultation Policy
- Medical Records Release Form
- FMLA/Paid Leave Request Paperwork
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