Empowering You to Get Back to Living
At Nebraska Spine + Pain Center, we want to do more than treat your pain and send you on your way. We want to empower you with the resources you need to feel well every day. Coming to us for a consultation is just the first step.
Schedule an appointment
Omaha – 402.496.0404
Lincoln – 402.323.8484
Forms and checklist for your first visit
To help your first visit run smoothly, we ask that you print and complete your patient information forms in advance. Access them through the patient portal and contact us with any questions.
Surgical Patient Presentations (Password Needed)
- Patient information forms
- Medical Records Release Form
- Photo identification
- Current insurance card
- List of current medications
- List of allergies
- Medical history
- Referring physician’s notes, if applicable
- Past MRI, CT or x-ray scans, or nerve conduction studies, if applicable
- Copay or required downpayment
- Auto accident liability form, if applicable
- Worker’s compensation form, if applicable
Come back to our website soon for complete information about Insurance, Wellness, Worker’s Compensation, FAQs, and a robust education center with details about the conditions we treat and procedures we offer.
In the meantime, please contact us by phone with any questions or concerns.