If you are a new patient please download and print the first five
forms and bring them with you to your appointment. You may need
Adobe Reader to open some of the files. A free download is below.
Just click on the following links.


Patient Medical History Form
Patient Insurance Information Form
Acknowledgement of Privacy Practice Notice
Authorization to Release Private Health Information
Medical Records Release Form
Workman's Compensation Insurance Form
Motor Vehicle Accident Insurance Information Form
Consent Form to Treat Minors
4701 Normal Blvd
Lincoln, NE 68506
Phone 402-488-5050
Capital Medical Clinic, LLP
Family Practice Medicine
healthcare, Family Practice,Family
Medicine,Family Doctor, Doctor Lincoln Nebraska,
Pediatrics, Physicians,Medical Clinic, kids
Internal Medicine, Weight Loss, pain management