Arbor Psychiatric & Wellness Center
Nebraska City, NE 68410
Phone:402.713.0110
Fax: 402.713.0285
Forms & Links
Use these forms if you are an existing patient needing to update paperwork or complete requested paperwork.
Here you can find a link to various forms you may be asked to complete, as well as information on No Surprises Act.
Click here to be taken to the patient portal where you can complete assigned measures, pay your bill, and update patient information.
NEW PATIENT PAPERWORK (Fill out if directed to by staff)
EXISTING PATIENT PAPERWORK 2026
ADDITIONAL FORMS
GOOD FAITH ESTIMATE/NO SURPRISES ACT
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
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You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
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Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
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If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
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Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 800-985-3059.