Appointment Request

The first step towards a powerful change is to schedule an appointment. Please contact our office by phone or complete the appointment request form below. Our scheduling coordinator will contact you to confirm your appointment.

All appointments begin with a free consultation. Everything will be explained including what can be done for your particular reporting issue. If you like what we have to say and we decide that you would be a good candidate for what we have to offer we will proceed with the appointment. If for some reason we decide not to proceed, the consultation will be at no charge. In other words, you get to be fully informed before any charges commence.

No shows will be charged as if you actually came to the appointment. In the same way that you don't sit at your employer for free, our time is valuable also. Please do not use this form to cancel or change an existing appointment. Changes to appointments need to be done over the phone at 402 393 0544. Leaving a message constitutes notice.

Patient Information

Patient Availability

Reason For Visit

Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.