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Patient Forms

Getting ready for your first appointment as a new patient with Heartland Cardiology is a breeze. Simply print out the following forms, complete them to the best of your ability and bring them along to your appointment.

Our Locations

Heartland Webb (Main)

3535 N. Webb Rd.
Wichita, KS 67226

Phone: 316-686-5300
Fax: 316-651-2660

Get Directions

Heartland West

9000 W. Central
Wichita, KS 67212

Phone: 316-686-5300
Fax: 316-651-1579

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Heartland Derby

1719 E. Cambridge
Ste 101
Derby, KS 67037

Phone: 316-686-5300
Fax: 316-558-8286

Get Directions

Heartland Newton

1525 N Main St
Newton, KS 67114

Phone: 316-686-5300
Fax: 316-333-1305

Get Directions

Affiliate Hospitals

Wesley Medical Center
Wesley Woodlawn Hospital & ER
Via Christi Hospital St. Francis
Via Christi Hospital St. Joseph
Via Christi Hospital St. Teresa
Kansas Medical Center
Robert Dole VA Medical Center
Kansas Heart Hospital

Affiliate Partners

EPIC Heart & Surgery Center

make an appointment

To schedule an appointment at any of our locations, please call 316-686-5300.

make an appointment