Please note, our Request Appointment form is simply a request. We will do our best to accommodate the date and time that works for you.
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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: 580-931-0500
Fax: 580-920-8027

Office Hours

Get in touch

580-931-0500