Patient Forms

Required Patient Registration and Treatment Forms

Please download the forms below, print them out, fill them out, and bring to your first appointment at Nebraska Urgent Care.

Patient Health History and Registration Form

Consent for Treatment Form

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New Hours 9am-1pm Daily

Nebraska Urgent Care is committed to providing safe access to healthcare during the COVID-19 pandemic.  The pandemic has had a major impact on the number of visits, and the time of these visits to our clinic.  To remain financially healthy, we have decided to change our hours of operation immediately.  We will now be open daily from 9am-1pm.  Thanks for your understanding and your business.