Mind Matters Mental Health and Wellness
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YOUR CART

Forms

Please print, fill out, and sign each form below and bring them to your first appointment.

​If you are age 19 or older, bring “Demographics for Independent Adults” and if you are 18 or younger, bring “Demographics for Minors and Those with Guardians”

Declaration of Practices and Procedures

Notice of Privacy Practices


Summary of the HIPAA Privacy Rule


Demographics for Independent Adults


Demographics for Minors and Those with Guardians


Presenting Problems and Concerns


Insurance Verification_Payment for Services Contract


Credit Card Authorization Form


​Referral Source Questionnaire
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Mind Matters is a private practice dedicated to providing the best mental health, counseling, and wellness services to those in Lincoln and its surrounding communities.

hello@mindmatterslincoln.com
(402) 631-1985







​
Proudly part of the Blue Cross Blue Shield network





Hours

MONDAY
8am - 8pm
TUESDAY
​8am - 8pm
WEDNESDAY
​8am - 8pm
THURSDAY
​8am - 8pm
FRIDAY
​8am - 8pm
SATURDAY
​8am - 8pm
SUNDAY
​8am - 8pm
Varies by Provider
Appointment Required.
Call, email or text to schedule.

Location

Located in Lincoln's Haymarket District:
700 R Street
​Lincoln, NE 68501

on the 3rd floor of the main Post Office building downtown, right next to Pinnacle Bank Arena. Clients park for free directly in front of the office.
​View Parking Map.

*Telehealth available!

Make an Appointment
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