Patient Form

For all new patients please print the following forms and bring them with you to your initial appointment.

Patient Information & Health History
- Patient Registration
- Health History

Acknowledgement of receipt of Notice of Privacy Practices

Other forms available:

Notice of Privacy Practices

Patient Records Access Form

Lincoln, NE

3901 Normal Blvd STE 202, Lincoln, NE 68506

Email: [email protected]

Office Hours

Monday7:30 am - 5:00 pm
Tuesday7:30 am - 5:00 pm
Wednesday7:30 am - 5:00 pm
Thursday7:30 am - 5:00 pm
FridayClosed
SaturdayClosed
SundayClosed