Patients First Medical Clinic LLC

Patient Forms

For your convenience, here are some of our new patient paperwork forms that you can download, print out, and fill out at home, before coming in to our office.

You will need:

1) The "Release For" (Patient Record of Disclosures, which tells us how we can contact you). It's in .pdf format

2) The Health History, 2 pages.

3) Patient Billing Information (tells us about your insurance)

4) Privacy Notice (this tells us you've read and understood the notice of our privacy practices - when and where we are allowed to give information about your visit with us to other entities).

• Release Form
• Health History
• Patient Billing Information
• Privacy Notice

Forms for Physicals

• Well Child Physical
• Pop Warner
• Commercial Driver Fitness

• Anchorage School District Sports Physical
• New To District Physical/ Kindergarten Physical
• ASD Asthma Action Plan
• ASD Allergy Action Plan
• ASD Long Term Medication Form
• ASD Forms Library

• ASQ-3 Family Access
• Modified Checklist For Autism In Toddlers

Milestone Moments Booklet