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OB/GYN - PEDIATRICS - FAMILY MEDICINE
BEHAVIORAL HEALTH
(402) 228-3117
4800 Hospital Parkway/U.S. Hwy 77 North, North Addition, Beatrice, NE

BWCC Clinic

Patient Forms

For your convenience, common patient forms are now included online. Select the appropriate form(s), print and complete. Please bring the forms with you to your next appointment.



New Patient Information

  

Release of Records

 

Consent to Treat Minor Child

 

Financial Assistance Policy

 

Tylenol / Motrin Dosing for Children

 

OB Intake Form

 

One Chart Child Proxy Form

 

Safe Common Medications / Treatment During Pregnancy

 

If you have any questions, please contact us.





 



 
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