New Patient Information
Helping your child’s first visit go smoothly
New Patient Forms and Information
Families may complete new patient forms at our office, get help from our staff,
or use the online form portal as a convenience.
What We Will Need
- Your child’s basic health information
- Dental and medical history
- Dental insurance information, if applicable
- Parent or guardian contact information
- Any details that may help us prepare for your child’s visit
How This Information Is Used
Our team uses this information to understand your child’s health history,
dental needs, insurance details, and any concerns you want us to know about.
It helps us provide safer, more personalized care and answer questions
during your child’s visit.
Insurance Information for Your Appointment
Papillion Pediatric Dentistry accepts most dental insurance plans. Please
bring your child’s dental insurance information to the appointment so our
team can help review your benefits and answer any insurance questions.
Our office also accepts Nebraska Medicaid through the three Heritage Health
managed care plans:
- Nebraska Total Care
- UnitedHealthcare Community Plan of Nebraska
- Molina Healthcare of Nebraska
If your child receives Nebraska Medicaid through Heritage Health, please
bring both cards to the appointment:
-
Medicaid card: The standard Medicaid card sent by the
Nebraska Department of Health and Human Services through ACCESSNebraska.
-
Heritage Health plan card: The card from your managed
care plan: Nebraska Total Care, UnitedHealthcare Community Plan of
Nebraska, or Molina Healthcare of Nebraska.
If you have questions about your child’s coverage, accepted insurance plans,
or which cards to bring, please call us before your visit. We are here to help!
Families are welcome to complete new patient forms at our office instead
of using the online portal.
If you plan to complete forms when you arrive, please come a few minutes
early so our staff can help and the forms can be finished before your
child’s scheduled appointment time.
Online Form Option
For convenience, new patient health forms may also be completed through a
secure, HIPAA-compliant outside portal provided by our dental software vendor.
The portal securely sends the completed information directly to our dental
practice software, which helps reduce the need for paper forms.
The portal opens in a new browser page. It is a safe option for submitting
new patient information, but it is not required in order to receive care.
Complete New Patient Forms
opens in a new page
If you have trouble opening, reading, or completing the online forms,
please call our office at 402.502.1256.
Our staff will gladly help you complete the needed information by phone,
in person, or when you arrive for your child’s appointment.