online services
practice forms
On this page we have included the forms that are required for some office visits. Our office staff will let you know if any of these are necessary. You may print them, fill them out, and bring them to the visit. This will help your visit to run more smoothly.
Online Form
Use our online patient forms for non-urgent requests only. For urgent requests, within 24 hours, please contact us by phone at 402-465-5600. Our office will contact you within 48 hours after receiving your online submission.
Appointment Request Form
Prenatal Consult Request Form
Patient Portal
Online Bill Pay
Well Child Visit Questionnaires
Medical History Form
Medical Records
If you would like to request that another office send records to Complete Children’s Health please fill out the following form.
Authorization to Get Records Form
If you would like to request that Complete Children’s Health send copies of records please fill out the following form.
Authorization to Release Records Form
In addition, many of your child’s records are found on and/or can be requested through the patient portal.
New Patient Forms
If you have questions about the medical records process you can view our Frequently Asked Questions by clicking here.
Asthma Clinic Forms
Behavioral Forms
Psychology Services Form
This form is specifically for use with appointments with our psychologists. You may download and print the form listed below and bring it to your appointment
LOCATIONS
3262 Salt Creek Circle, Lincoln, NE 68504
4020 Hohensee Drive, Lincoln, NE 68516
8201 Northwoods Drive, Lincoln, NE 68505
1336 West A St, Suite B Lincoln, NE 68522
Phone: 402-465-5600
Fax: 402-327-6074
HOURS
Office/Phone Hours
8:00 am to 5:00 pm Monday - Friday
9:30 am to 3:30 pm - Saturday
9:30 am to 1:30 pm - Sunday
Clinic Hours
8:45 to 4:30 Monday - Friday
Evening/Weekend Clinic Hours
West A Location Only
Sick visits only, appointments required
Monday - Thursday starting at 5:30
Saturday 9:00 am - 4:00 pm
Sunday 10:00 am - 2:00 pm