• Symptoms of COVID-19 / Coronavirus MAY Include:

  • * Fever at or above 100.4
  • * Cough
  • * Shortness of breath
  • * Difficulty breathing

* If you have answered YES to any of the  above, please call our office at 402-421-3240 to  speak with your provider’s nurse. If you have an  appointment coming up and have any of these  symptoms, please call the office for further instructions.

Everyday Precautions for COVID-19:

  • * Avoid close contact with individuals who are sick.
  • * Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
  • * If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
  • * To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
  • * Wash your hands after touching surfaces in public places.
  • * Avoid touching your face, nose, eyes, etc.
  • * Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)
  • * Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
  • * Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.

This questionnaire is to be filled out prior to making any initial appointment. Please make sure to have these completely filled out and Sent to the appropriate staff member. DOWNLOAD FORM

This packet is to be filled out prior to your initial appointment. Please make sure to have these completely filled out and bring them with you to your scheduled appointment. DOWNLOAD FORM

If your office visit is due to a work accident, please fill out the appropriate information on this form and bring it with you to your appointment. DOWNLOAD FORM

If your office visit is due to an auto accident, please fill out the appropriate information on this form and bring it with you to your appointment. DOWNLOAD FORM

If you would like your records sent somewhere outside of our office we will need this form sent in to us completed.. DOWNLOAD FORM

A simple questionnaire for Medicare recipients. . DOWNLOAD FORM

This form allows you to submit a complaint in writing to the clinic. Please mail it to the office at 3901 Pine Lake Rd, Ste 220 Lincoln, NE 68516 attention Gloria or HIPAA Compliance/Safety Officer. A staff member will follow up on the complaint. Complaints may also be called in to the clinic.  DOWNLOAD FORM