New Patients

Come to your appointment at least 15 min early to complete the necessary paperwork.

To minimize your wait time during the visit to Dr. Izadi's office, you will need the following:

1. Print and fill out the following three forms:
​

• MD West ONE Patient Registration                                   
• Medical History Form
• Receipt of HIPAA Acknowledgment and Financial Authorization         

           
2. Any medical records pertaining to your current condition
3. Any studies (X-ray, MRI, CT, nerve studies) with reports pertaining to your current condition 
4. Insurance card 
5. Valid ID

You do not need to bring this form to your appointment, however please review:

• View MD West ONE Notice of Privacy Practices
• View MD West ONE Financial Policy

If you have any questions regarding the forms, please contact Dr. Izadi's office at (402) 390-411.

Work Comp Patients

1. Contact our workers compensation liaison, at (402) 361-5234 and provide her with: 

• Your case worker's name and phone number
• Your supervisor's name and phone number

2. Schedule an appointment with Dr. Izadi at (402) 390-4111.
3. Print and fill out the following forms:    

• ​MD West ONE Patient Registration
• Medical History Form
• Receipt of HIPAA Acknowledgment and Financial Authorization ​

3. Bring to your appointment:

• Any medical records on your current condition
• Any studies (X-ray, MRI, CT, nerve studies) with reports on your current condition 
• Valid ID 

4. You do not need to bring this form to your appointment, however please review:

• View MD West ONE Notice of Privacy Practices
• View MD West ONE Financial Policy​

You are always welcome to call my office at (402) 390-4111 with any questions prior to making an appointment.