Omaha Office:
(402) 614-8444
1941 S. 42nd Street, #328, Omaha NE 68105

Fremont Office:

(402) 727-1592
230 E. 22nd Street, #4, Fremont NE 68025

Schedule Appointment

Patient Intake Forms

Please complete and submit each of these forms ahead of your scheduled appointment:

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Client Orientation Checklist

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Client Rights and Responsibilities

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Consent to Release Information

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New Client Information Form

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Consent to Treat Client/Minor

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Statement of Advance Directive

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Telehealth Consent Form

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Primary Care Physician Refusal

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Patient Information & Policies