Suicide PreventionNational Suicide Prevention Lifeline: 1-800-273-8255.
Suicide Prevention Lifeline
The Kim Foundation
Billing QuestionsFor help with your current bill, call 402-395-2191 and ask for Patient Financial Services.
For help with a bill that is past due:
- If you got the bill before January 2, 2018, call 402-395-3268.
- If you got the bill after January 2, 2018, call 308-398-3955.
For a loan to help pay off your medical bills, call Nancy at Cornerstone Bank 402-395-2151.
Need insurance you can afford? Call Cierra at 1-866-466-9339 to set up a time to find out your choices.
Flu "Shot on the Spot" FormsFlu Shot Consent Form
Flu Shot for Insurance Submission Form
Sports Physical RegistrationSports Physical Consent Form
Healthcare RightsFinancial Assistance Covered Providers
Financial Assistance Policy
Financial Assistance Summary
Patient Bill of Rights
Patient FormsTitle it Sports Physical Registration Form
Financial Assistance Application
Release of Health Information Form
Patient Service Agreement Clinic - Outpatients
Patient Service Agreement Clinic - Outpatients - Spanish
Patient Service Agreement
Patient Service Agreement - Spanish
Resources2015 Community Health Needs Assessment
Patient/Visitor Grievance Form
Health Insurance Marketplace Authorization Form
Functional Needs Registry Information
Dispose of unused, unwanted, or expired medications