Patient Info

Patient Forms

Fill out your paperwork before your appointment so your visit can move smoothly.

Download Patient Forms

Download and print the adult or child medical history form and the HIPAA notice below to prepare for your visit.

Download Adult Medical HistoryPDF · 1 page · 576 KB
Download Child Medical HistoryPDF · 1 page · 485 KB
Download HIPAA Notice of Privacy PracticesPDF · 2 pages · 1.5 MB

Need Help With Your Forms?

These PDFs are scanned documents and may not be readable with a screen reader. If you need help accessing or completing them, or have questions about which forms to use, please call: existing patients, (402) 947-5111; new patients, (402) 576-0591.

Have another question before your visit? Contact us — we’re happy to help.