Please fill out this form as completely as possible and one of our staff will be in touch. Remember do not send personal health information through this form. Specific patient care will be addressed during your appointment.
Request Appointment
By submitting this form you agree to receive SMS messages from Nebraska Visual Integration Center. Carrier message and data rates may apply. Message frequency may vary. Reply STOP to opt out of further messaging or reply HELP for more information. Additional information can be found in our privacy policy.