Patient Forms

Heartland X-Ray offers our patient forms online so they can be completed in the convenience of your own home or office. Completing them prior to arriving at the clinic for your first appointment will save you significant time on your visit.

Instructions: click on the necessary form, fill it out, and submit it online.

X-Ray Consent Form – Required

This must be filled out BEFORE any assessment or treatment can be given.

COVID-19 Screening Form

Please fill out this form prior to your appointment and let us know you have completed it when you arrive.