Dr. Max. M. Martin, Jr.
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.

NEW PATIENT FORM ONE

NEW PATIENT FORM TWO

 ACKNOWLEDGEMENT OF RECEIPT OF
NOTICE OF PRIVACY PRACTICES

NOTICE OF PRIVACY PRACTICES