Online Patient Registration Forms
Save time by pre-registering with our office! To begin your registration process, click on the link below at the location you have scheduled your appointment.
The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it. This online patient registration is encrypted, secure and HIPAA compliant.
If an unforeseen circumstance requires you to change or cancel your scheduled appointment, we request 48 hours notice.
Please select the office link below where your appointment is scheduled.
Location: 201 Ridge Street – The Doctors Building at Jennie Edmunson
Doctors: Dr. David Marshall, Dr. John Andersen, Dr. Jim Heit
Location: 1437 East 23rd Street
Doctors: Dr. Steve Wendt, Dr. Corey Auch
Location: 1502 So. Washington Street
Doctors: Dr. Jim Heit
Information about our secure online patient registration form can be found here:
https://pbhssupport.zendesk.com/hc/en-us/articles/200164224-TruForm-Classic-Security-Information. Please contact us with any questions.