Patient Forms

READY TO GET STARTED?
Secure, Convenient, and Confidential

All our forms are 100% HIPAA-compliant and securely hosted via JotForm. None of your responses are stored on this website, and all submissions are encrypted to protect your privacy. Please complete the required forms (listed with an asterisk) before your appointment. All other forms are listed as optional.

If you have questions or prefer to speak with someone, don’t hesitate to give us a call.

INSURANCE QUESTIONS?
We accept most Blue Cross/Blue Shield, Cigna, and Aetna. We do NOT accept UMR/Optum or Medicare/Medicaid or Tricare.

Uninsured? Out of Network?
Our fees are transparent and found on our Financial Policies page. We are happy to provide you superbills to request a reimbursement from your insurance.

Need help? Call Us at 402-252-3833
























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