New Patient Forms

New patient forms for our clinic

To expedite your visit, please download, print, and fill out all of the forms to the right at home and bring them with you to your first appointment at our patient’s clinic in Anchorage, AK. This way a practitioner can attend to you or your child as soon as possible. All patients need to have these forms filled out by their guardian, if under age, in order to receive our medical care.
The purpose of the new patient forms is for our practitioners to have an understanding of you or your child’s health condition prior to your visit at our patient’s clinic, as well as have the child’s guardian contact information in the event of an emergency and test results. Furthermore, we would like to know your insurance details for billing purposes and finally a privacy notice stating that the patient or guardian understands the notice of our privacy practices.
Share by: