New Patient Paperwork
Thank you for choosing Lincoln Wellness Center for your health needs. We look forward to seeing you at your new patient appointment and are excited to help you in your journey to health! Let’s get started!
Please complete both steps below a minimum of three (3) business days prior to your new patient appointment.
- PDF files must be saved to your desktop before and after completing.
- All forms are PDF files. You will need AdobeReader® to view them. If you do not already have AdobeReader® installed on your computer,
Click Here to download.
STEP ONE:
Complete the Health History Questionnaire below and email this document to office@lincolnwellnesscenter.com
Attention Parents/Guardians: If you have a child age 10 or under, you will need to complete the Pediatric History Form and not the Health History Questionnaire listed above.
STEP TWO:
Functional Assessment Questionnaire:
Complete the Functional Assessment Questionnaire online. This health review takes approximately 30 to 40 minutes to complete.
OFFICE HOURS
Monday
9:00am - 11:30am
Tuesday
3:30pm - 6:00pm
Wednesday
9:00am - 10:30am
3:30pm - 6:00pm
Thursday
3:30pm - 6:00pm
Friday
Virtual Consultations
Closed in the Afternoon
Saturday & Sunday
Closed
Lincoln Wellness Center
1777 N 86th St, STE 102
Lincoln, NE 68505