Open Mon-Fri 7:30am-6pm • Saturday 9am-2pm
907-279-8486
General demographic and insurance information.
Tell us how how to contact you.
This notice describes how health information about you may be used and disclosed and how you can get access to this information.
Permit us to receive medical records from previous or other providers, if applicable.
Share your medical history with your provider team. Please note these forms are age specific.
Indicate your preference regarding who may bring your child for medical care and whether we may see your older child without you present.
Know what to expect regarding paying for your care.
Permit us to receive drug and alcohol treatment information, if applicable.