Fill out the above forms or please print, completed and bring in any required forms to your next appointment. 

Patient Registration -pdf (Or Complete the above online form)
Medical History - pdf 
(Or Complete the above online form)
Release of Information - pdf
Notice of Privacy Practice - pdf

 The documents above are provided in a printer friendly PDF format. A PDF viewer such as Adobe Reader is required to view the documents.

Note: We have consolidated our locations to better serve our patients, our main location is now in Fairbanks.

Fairbanks

  • 751 Old Richardson Hwy
    Suite 200, Fairbanks, AK 99701
    Office: 907-770-2606
    Fax: 907-290-2522
    Mon-Fri: 9:00 am-5:00 pm
    Map