Your first visit to The Foot and Ankle Center of Nebraska involves a few special steps so that we can get to know you. To understand what to expect, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more. There's also background information about our committed staff and our first visit procedures. You can also save some time by printing out and completing the patient forms in advance of your appointment.
At our first visit, we will need you to fill out a number of forms on demographics and medical history. You may fill out these forms online or hard copy. To fill out the copy online, please contact the office and provide an email address to be added to our secure patient portal. Access will only be granted via a link to your email inbox after an appointment has been set up. You must be granted access before attempting to log-in. Once you have a login, you may access the patient portal by following the link above or by clicking here.
You may also print and fill out the forms below. Please noted there are forms that are needed specifically for remote telehealth visits.
New Telehealth specific forms:
All other forms
- New Patient Demographics Form (English)
- Financial Policies and Consent to Treat (English)
- Authorization for Release of Medical Information (English)
- New Patient Medical History - Page 1 (English)
- New Patient Medical History - Page 2 (English)
- Nondiscrimination Notice (English)
- New Patient Demographics Form (Spanish)
- Financial Policies and Consent to Treat (Spanish)
- Authorization for Release of Medical Information (Spanish)
- Nondiscrimination Notice (Spanish)
- Nondiscrimination Notice (Chinese)
- Nondiscrimination Notice (Vietnamese)
- Nondiscrimination Notice (Afrikaans)
- Nondiscrimination Notice (Arabic)
In order to view or print these forms, you will need Adobe Acrobat Reader installed. Click here to download it.
Dodge Street Office:
Local Landmarks: Our office is located on the south side of Dodge Street, across from the Crossroads Mall, next door to Verizon Phone.
Public transportation stop: Available at Crossroads Mall by Target
Grover Street Office
Local Landmarks: Located in the Grover Square shopping center across from Grover Plaza and Bag N Save.
Public transportation stop: Stops are located on the NW corner of 50th and Grover and the SW corner of 52nd and Grover
La Vista Street Office:
Local Landmarks: Local landmarks: Our office is located northeast of 84th and Giles Road in the Brentwood Village Shopping Center behind Fazoli's and next to Gamers.
Public transportation stop: Available on the Southwest corner of 84th and Giles.