11200 Winner Road
Independence, MO 64052
1717 N. Main Street
Higginsville, MO 64037
Phone: (816) 228-4770
Fax: (816) 228-1156
through the patient portal. Schedule apptointments,
online billpay, talk to a nurse, and much more.
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On line bill pay now available.
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New patients may choose to print the following forms to be filled out prior to your appointment. Please bring the completed form(s) with you to your appointment. Also if you have had an address or insurance change you may be required to complete the information sheet again. Please call us if you have any questions about completing these forms.
- Patient Information sheet
- Financial Policy
- Missed Appointment Policy
If you are requesting copies of your child's chart or requesting that your child's chart be transferred, you will need to complete the medical records request form and either fax, mail or bring it into the office. Charges will apply for those needing to transfer their entire record. If you have questions regarding the status of your records please call DataFile Technologies: 816-437-9134
If your child is 18 years and over and needs to give consent for the parents / legal guardians to have access to his chart, you will need to have the patient sign the form below to grant that permission.
To contact Medical Records
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