Patient Portal & Forms
Heartland Plastic Surgery Patient Portal
or REGISTER for myPatientVisit Portal by following the steps below.
Step 1: Enter Basic Information
- 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.
Step 2: Select Security Questions
Select three security questions and answer them. Click Continue
Step 3: Pre-Register for Appointment by Filling out Paperwork
Once logged in, click the pre-register button next to your scheduled appointment to fill out your mandatory patient paperwork.
Ready to begin? Begin your myPatientVisit Portal Registration below:
Please be rest assured that all information provided is kept confidential, secure, and HIPAA compliant. Please call the office at (573) 837-1610 if you have any questions.
Thanks again and we look forward to seeing you at your appointment!
Need additional help?
- 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 (573) 837-1610 and we’ll be happy to assist.
- Still need assistance? Call (573) 837-1610 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