Photo by Lindbeck Photography

Dr. Stuart G. Lacey
Dr. Travis J. Antholz
Dr. Sarah C. Donner

3445 "O" Street
Lincoln, Nebraska 68510
(402) 474-3445

At Lacey-Antholz-Donner Dentists P.C., we will collect a complete record of your health information to ensure the best management of your dental health. Please click on the forms below. Having these forms filled out prior to your dental appointment and can help you save time the day of your appointment and so that we may update your records.


NEW PATIENT FORM
Download our new patient form, print off, complete, and bring to your appointment.



 ACKNOWLEDGEMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES
NOTICE OF PRIVACY PRACTICES

Please assist us by providing the following information at the time of your visit:
any current x-rays, list of medications, dental insurance information,
or any need for antibiotic pre-medication
.


Please click here to download adobe reader so that you may access the above forms.


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