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8419 S 73rd Plaza Suite 104 & 107Papillion, NE 68046(402) 898-8500

Patient Forms

First-Time Patient Forms

Our patient forms can be saved and printed by clicking the pdf buttons below. Please fill out these forms and bring each form before your first visit.

Patient Intake History

Protected Health Information (PHI)

Receipt of Notice of Privacy Practices

New Patient General Information Form

Personal Release

Consent to Outpatient Services

No-Show Policy Form

Post-Operative Sheets

Our post-operative sheets can be saved and printed by clicking the pdf buttons below.

Bowel Prep Patient Sheet

Post-Operative Abdominal Hysterectomy Instructions

Post-Operative Anterior and/or Posterior Repair for Bladder or Rectal Prolapse Instructions

Post-Operative Colposcopy Instructions

Post-Operative Dilation and Curettage Instructions

Post-Operative Exploratory Laparotomy Instructions

Post-Operative Hysteroscopy Instructions

Post-Operative Laparoscopy Instructions

Post-Operative LEEP Procedure Instructions

Post-Operative Abdominal Myomectomy Instructions

Post-Operative Sling/Cystoscopy Instructions

Post-Operative Vaginal Hysterectomy Instructions

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At MyDoc, the level of care you receive will be managed by professionals—professionals who have your best interest at heart. Our staff includes two board certified physicians. Together we have over 40+ years experience in the medical field.

Contact Us

8419 S 73rd Plaza Suite 104 & 107
Papillion, NE 68046
Telephone: (402) 898-8500
Fax: (402) 898-8510

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