Forms

Telepsychology

Informed Consent for Telepsychology

Please either fax the signed form back to the office (402.488.6210), email as an attachment, or take a picture of it and attach to an email sent to tamimbblincoln@gmail.com.

Start a telemedicine call with
Dr. Love

New Patient

Adult Intake Form

Youth Intake Form

Psychologist Patient Services Agreement

Demographic Information

General

Release of Information