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Lifecare Family Medicine

Helping you live a healthier life!

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MENUMENU
  • Home
    • About Us
    • Notice of Privacy Practices
  • PATIENT SERVICES
    • Appointment Request
    • Your First Visit
    • Immunizations & Vaccines
    • Laboratory Services
  • Patient Forms
  • Healthcare Team
    • Brian J. Finley, MD
    • Peggy Hobus, R.N., M.S.N., A.P.R.N.
    • Sarah Rawley, A.P.R.N.
  • Billing & Insurance
    • Billing Process
  • Patient Portal

PATIENT FORMS

The following forms are made available in their electronic format for your convenience.  Please feel free to download and complete the forms prior to your appointment.

Download LCFM Financial Policy

Download LCFM Patient Authorization of Disclosure

Download LCFM Authorization for Release of Medical Records

Download LCFM Patient Information Sheet

Download LCFM Patient Portal Consent

Download LCFM Notice of Privacy Practices Receipt

Get in touch

  • (402) 779-7207
  • info@lifecarefm.com
  • www.lifecarefm.com
  • 2510 Bellevue Medical Center Drive
    Suite 145-A
    Bellevue, NE 68123
  • Monday, Wednesday and Friday
    8:30 a.m. to 5 p.m.

    Tuesday and Thursday
    8:30 a.m. to 7 p.m.

Fax number

(402) 779-7210
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