Forms

New patients have the option of downloading and printing the Demograhic Data/Information form at the convenience of their homes. This will save you valuable time when you arrive for your initial consultation. We also request you bring relevant medical records and your billing information at the time of your appointment. In addition, we require that you sign the Notice of Privacy Information Practices and Acknowledgement of Privacy Practices forms and bring them with you at the time of your consultation. Thank you. 

Adobe Acrobat reader is required for these forms. If you do not have it, download it here.

Location

Our office is conveniently located in the

Providence Alaska Medical Center Campus at

3300 Providence Drive, Building B. Suite 114.

Anchorage Alaska 99508.

Telephone : (907) 770-6200 / Fax : (907) 770-6202

   
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