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Forms available to print off, fill out and bring along with you to your appointment...

HEALTH INFORMATION

  • Phone: 402 844 8018
  • Fax: 402 844 8045

We are a covered entity under the Rules and Regulations of HIPAA. All release of information requests must be HIPAA compliant.
Release of Information - We fax, mail or patient can hand carry records.

  • Sending to another physician's office, No Charge to patient or physician
  • Receiving from another physician's office, No Charge
  • Personal Use: No Charge up to 6 pages. If 7 or more pages, Fifty Cents per page from page 1
  • Processing Time: 7 - 10 business days, unless an appointment is scheduled with another physician.

 

 

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