The following documents can be used for your benefit.  By downloading and completing the intake and consent forms, you will decrease the amount of time spent in the office on your first visit.  Of course if you have any questions, you can contact us through our Contact Us page, or call us at 402-210-1472.
 Patient Intake Forms
PatientConsent.pdf
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Patient information and consent form (must be signed by parent or guardian if under 19 years of age).  1432k v. 2 Aug 15, 2011 3:40 PM Jeffrey Cumro
PatientIntake2.docx
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Patient identifying and insurance information.  64k v. 2 Aug 15, 2011 3:40 PM Jeffrey Cumro
PatientIntakeForm.pdf
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Patient history form.  128k v. 2 Aug 15, 2011 3:40 PM Jeffrey Cumro