4130 S. 144th St., Omaha, NE 68137          (402) 505-4148

For new patients, there can be a great deal of paperwork to fill out. Our new patient center offers education about the kinds of ailments we can treat, our treatment options, and more. We also make the process easier by allowing you to fill the paperwork out here, in our new patient center, any time before your appointment.


If using Internet Explorer to access this form, please use version 7 or higher.
Please note that all data is encrypted as it’s passed to our system, so all patient sensitive information remains secure!

So for those patients who do not have this browser support at home, they can either come into our office before their visit (10-15 minutes to complete on the computer, automatically going into our secure database). Or they can use the PDF version available below, print and bring in with them to their visit.

If you do not wish to fill out the online form, you can download a PDF version of our form here.