New Physician Profile Information Form

Welcome to Children’s Nebraska!

We look forward to introducing you to the medical community at Children’s and regionally; but we need some information to accurately describe your accomplishments in our publications and online.

Please view some examples from our Provider Directory.

Please use proper names of academic and health care institutions as you complete the form below.

When you have completed the form, you will be contacted regarding a professional photo appointment. Please schedule this as soon as possible.

*Required fields marked with * must be completed for a successful submission.


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