New Patient Forms

New Patient Registration

Click the below link to start your new patient registration.

You must have a security code to begin this process or user name and password to log into the secured portion of this website.

Please call (814) 453-4482 to obtain your security code information.

Start Online Patient Registration

Patient Forms

To expedite your office visit, you may download and complete the following forms before your appointment.

Please call us at (814) 453-4482 if you have any questions regarding the forms or consultation.

Patient Intake Form

Patient Consent Form

Financial Policy


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Specials & Events

Save on non-surgical treatments like Botox, injectable fillers or laser therapy. Sign up to receive email specials and you'll learn about our current offerings. more...

What’s New

Our plastic surgery practice uses the latest aesthetic technology and products. Dr. Heaney trusts technology like the Candela Laser to improve the health and beauty of skin. He also provides injectable treatments to smooth skin and reduce wrinkles without surgery.