2490 S. Woodworth Loop, #450
Palmer, AK 99645
Call Us
907-745-8100

Patient Forms

PATIENT REGISTRATION FORMS

If you are not able to complete the registration process using our interactive Patient Portal, please PRINT THE FORM and COMPLETE ALL PAGES OF THE FORM, and bring it with you to your appointment.  Please bring a valid ID, insurance cards and a completed medication list as well.

MEDICAL RELEASE

NOTICE OF PRIVACY PRACTICES

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