Patient Forms
To expedite your visit, please download, print, and fill out all forms in the box below and bring them completed to your first appointment.
This way a practitioner can attend to you or your family member or child as soon as possible. All patients need to have these forms filled out by their guardian, if under age 18, in order to receive medical care.
New to our Clinic?
The purpose of the new patient forms is for our practitioners to have an understanding of you or your family member's health condition prior to your visit at our medical clinic. We also require emergency contact information for you or a child especially if accompanied by a legal guardian to the appointment. We will need to know your insurance information for billing purposes. Finally, a privacy notice stating that the patient or legal guardian understands the notice of our privacy practices also must be completed.
Click on the box to download the required forms prior to your visit.
Adult Forms
All Adults are encouraged to have an annual exam to review their health history, measure vital signs such as blood pressure, weight, have a complete a physical exam and have lab work performed to review critical health indicators such as blood sugar, cholesterol and kidney function tests. Our Family Nurse Practitioners and Physician Assistant have experience in managing chronic health conditions and can help guide you to reach your health goals.
We are also Federal Motor Carrier Safety Administration (FMCSA) certified medical examiners to provide your physicals for your DOT/CDL. In addition, we perform physical exams and lab work for surgical or employment clearance.
Click on the box to download the required forms prior to your visit.
Adult Patient Forms
Adult Physical Exam Form
Children & Teen
Physical Forms
Physical Forms
Committed to excellence in our medical care clinic, Patients First Medical Clinic uses only the most trusted testing methods for detection, diagnosis and treatment of children and teen illnesses and diseases.
To ensure top health of your child, health tests and screening are highly recommended, as well as required by the Anchorage school district. Click on the box that corresponds with your child's age to download the required forms prior to your visit.
Children & Teen
Physical Forms
Infants and Children Younger Than Age 6
Children Ages 6-11 Physical Forms
Children & Teens Ages 12 - 21 Physical Forms
Anchorage School District Sports Physical
New to District Physical/ Kindergarden Physical
ASD Asthma Action Plan
ASD Allergy Action Plan
ASD Long Term Medication Form
ASD Forms Library
Physical Forms
Children's developmental screening tests in Anchorage, AK
As a part of a yearly physical exam, all children and teens should be screened for their development to assure they are growing and developing to their full potential. We have made the links to screening tools for children ages 0-5 available on our web site.
Click on the green box and it will take you to the Ages and Stages screening tool. This is free to all of our patients. If you can print out the results of the screening tool and bring it with you, this will be helpful.
There is also a tool call the M-Chat available to screen young children ages 16-30 months for autism. This is also free. If your child is between 16-30 months, please complete this prior to the visit or any time you have concerns.
Your health care provider will go over the results of the test at the time of your appointment and tell you what the score it means. The provider can also assist you with referrals for special therapies or other medical care if indicated.
You can also obtain a Milestone Moments Booklet at the appointment or on line and this will give you an idea of what milestones to expect for children ages 0-5.