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Call for an appointment

402.502.1256

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Health forms

We have made the forms easier to complete by allowing you to fill in the form using your computer keyboard. You may use your computer to complete the forms and then print them, sign, and bring the forms to the office (preferred). Or you may print the blank forms and fill them in using a pen, sign and bring the form with you to the office. NOTE: Filling in the forms only works on a computer and not on a phone or tablet.

HEALTH FORM WITH HIPPA CONSENT AND ACKNOWLEDGEMENTHIPAA Notice of Privacy Practices - Must read!HIPAA Aviso de prácticas de privacidad - Debe leer!