New Patient Application

Application Form

To apply to become a patient of Think please download the application form here, complete it and either email the completed form to info@thinkhealthcare.org or post it to us at:

Think Whole Person Healthcare P.O. Box 241360, Omaha, NE 68124-5360
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Release Form

Marty Mancuso, M.D.
Kirk Muffly, M.D.
Will Ostdiek, M.D.
Tim Crnkovich, M.D.
Stuart Frigyes, M.D.

If you have been a patient of the physicians listed above please download a release form here, complete it and either email the completed form to info@thinkhealthcare.org or post it to us along with your completed application form to:

Think Whole Person Healthcare P.O. Box 241360, Omaha, NE 68124-5360

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Download Patient Application Form

Download Records Release Form

Download Psychotherapy Notes Release Form

Have a question? Email us