INSTRUCTIONS
Everyone must complete the New Patient Packet. Please click here to fill out paperwork online at: https://intakeq.com/new/kkdpqu

 

Nebraska residents without insurance, that would like to qualify for our sliding fee scale, must complete the Region paperwork and bring required documentation listed with them on their first visit. Please be advised, required documentation must be present at first visit in order to continue with appointment. If documentation is not received in full, your appointment will be rescheduled. Some restrictions apply. Please call our office for more details. 

 

You may complete a Release of Information if you have a specific person or entity you want us to send or receive information to/from. For example, your primary care provider, school, or therapist.  

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For all other providers please contact our office and we will be happy to email, mail, or fax you new patient paperwork.