Your first visit to The Foot and Ankle Center of Nebraska involves a few special steps so that we can get to know you. To understand what to expect, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. There's also background information about our committed staff and our first visit procedures. You can also save some time by printing out and completing the patient forms in advance of your appointment.
Patient Forms
To expedite your first visit, please print and fill out these forms.
You may also contact the office and provide an email address to fill out these forms online with our secure patient portal. Access will only be granted via a link to your email inbox after an appointment has been set up.
- New Patient Demographics Form
- Financial Policies and Consent to Treat
- Authorization for Release of Medical Information
- New Patient Medical History (Page 1)
- New Patient Medical History (Page 2)
- Nondiscrimination Notice (English)
- Nondiscrimination Notice (Spanish)
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.