Request an Appointment
Please do not use this form if you have an urgent medical problem or you need to reschedule an existing appointment. Instead, contact our office at (913) 451-0600. After you submit your request, our appointment scheduler will respond within 48 hours. See below for forms to complete.
Patient Registration Forms
Midwest Hemorrhoid Treatment Center in Leawood, Kansas welcomes you to our practice. Once you have made your initial appointment, you may preregister online by completing the downloadable form(s) below, and bring them with you to your first visit.
Also, be sure to bring any diagnostic films or other test results that may have been ordered or performed by another Physician.
Downloadable Forms:
Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.
