Below you will find our Medical History Form. You can either fill it out online and submit it electronically before your appointment, or you can click here to print it so that you may fill it out and bring it to your appointment. This is a secure form and is HIPAA Compliant.
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We are standing by to help you achieve your unique skin goals. Please contact us using our contact form, or give us a call at any one of our three locations in Salina, Hays & Great Bend.
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Thank you for visiting Heartland Dermatology! Please contact us using our contact form, or give us a call at any one of our three locations in Salina, Hays & Great Bend.
Salina Office Hours: 8:00 AM to 5:00 PM Monday through Friday. Great Bend Office Hours: 8:00AM to 5:00PM Monday through Thursday. Hays Office Hours: 8:00AM – 5:00PM Monday through Thursday and 8:00AM through 12:00PM on Friday.