New Counseling Patient Forms

Welcome to Lincoln Family Medical Group Counseling

Please complete the following FOUR forms prior to your first session.

Patient Demographic Form Counseling Informed Consent Telehealth Informed Consent Release of Information

Additional counseling intake forms for individual, couples, and child counseling will be added digitally in the future.

If you are unable to submit these forms digitally, they may also be printed and brought to your appointment.

Print Demographic Form Print Counseling Consent Print Telehealth Consent Print Release of Information

For Your Appointment

  • Please arrive 15 minutes prior to your scheduled appointment time.
  • Any applicable copay will be collected at check-in.
  • If you are scheduled for teletherapy, we will contact you prior to your appointment to collect any applicable copay.

Questions?

Call 402-488-7400 Text 402-662-6765