Patient Registration Forms

Complete Your Forms Online or Download

Welcome! To make your first visit as smooth as possible, you can fill out your patient registration form directly on this page. It’s quick, secure, and saves time at check-in.

Once you’ve completed the form below, just click “Download” to save a copy with your information already filled in. You can print it and bring it with you to your appointment, no handwriting required.

A happy family and clients of Internal Medicine and Family Physicians of Omaha.

Need Assistance?

We’re here to help.

If you have any questions while completing your form or prefer to fill it out by hand, feel free to reach out. Our team is happy to walk you through it or provide a paper copy.

(402) 758-5800

Download the Form Below?

If you’d rather complete the form manually, you can simple print the below form and write on it. Or you can open in a PDF view and fill it out before you arrive.

Health Tips from Our Providers

Our Omaha care team shares plain-spoken, evidence-based tips. Like the easiest way to keep blood pressure in check, when to choose a virtual visit, and how to read your own lab numbers, so you can stay healthy between appointments and make medical decisions with confidence.

17030 Lakeside Hills Plz Ste 102, Omaha, NE 68130

Our office is located within Lakeside Two Professional Center, immediately South of Lakeside Hospital. It is easiest to park along the west side of Lakeside Two and enter from the main entrance.