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Request an Appointment 

FREMONT OFFICE

1835 E MILITARY ST #111

FREMONT, NE 68025

OAKLAND OFFICE

212 N OAKLAND DR

OAKLAND, NE 68045

Please be sure to fill out the form completely.

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​We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form. Our registration forms are all HIPPA compliant.

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Appointments are between 8 am - 8 pm.

Monday in Fremont                                 Tuesday in Fremont

Wednesday in Oakland                          Thursday in Fremont

Friday in Fremont & in Oakland

We are looking forward to meeting you!

Client Information:

DOB of client
Month
Day
Year
Sex
Multi-line address

Responsible Party, Guardian if different then the client.

Which Office works for you?
Fremont, NE
Oakland, NE
How will you join?
In-person
Virtually
Which day(s) of the week work best for you?
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