Patient Forms


 

Feel free to print these forms and bring them with you during your visit

Otherwise, please arrive 15 minutes prior to your first appointment to complete a questionnaire and patient medical history information.

Before you leave, make sure that you have completed and turned in your Patient Portal Authorization to the receptionist. You can have access to your medical information through our secure online portal.


New Patient Info Form

Patient Portal Authorization Form

Stress Test Form

Medical Release Form

Collection Request Form

EECP Therapy Form

What we offer

Services and Conditions

Location
The Heart and Medical Center and Urgent Care
2701 W. University Blvd.
Durant, OK 74701
Phone: 580-200-2280
Fax: 580-920-8027
Office Hours

Get in touch

580-200-2280