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

Dry Night Clinic Forms
Influenza Clinic 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

New Patient Forms

If you have questions about the medical records process you can view our Frequently Asked Questions by clicking here.

New Patient Packet
Prenatal Packet

Developmental Form
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

New Psychology Patient Form
Release Psychology Records

Additional Resources

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 to 5:00 Monday - Friday

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 12:00 pm - 4:00 pm