Alaska Foot and Ankle Specialists is committed to making your office visit, an easy and comfortable experience. Below are external web links and PDF copies of our patient forms. The PDF forms below were created for your convenience and require a copy of Adobe Reader software installed on your computer. Download a free copy of Adobe Acrobat.
Interactive PDF Forms & Instructions:
1. Click on the file name below to download a copy to your computer.
2. Open the interactive PDF file in Acrobat software.
3. Make sure the interactive form fields are highlighted for ease-of-use.
4. Enter all applicable information in the interactive PDF form.
5. Print a copy, complete any sections requiring handwritten responses then sign and return to our office at your next scheduled visit.
• New Patient Form (Interactive PDF)
• Patient Authorization For Use and Disclosure of Protected Health Information Form (Interactive PDF)
Authorization to Treat Minors Form & Instructions:
Please return the completed form below to our office at your next scheduled visit.
• Authorization to Treat Minor in Absence of Parent/Guardian (PDF)
Release of Patient Records Form & Instructions:
Fax or mail the completed form to our office for records release processing.
• Records Release (PDF)
Policy Forms:
• Notice Of Privacy Practices (PDF)
• Patient Financial Policy Sheet (PDF)
External Web Links:
• Alaska Surgery Center Patient Pre-Registration
• Alaska Regional Hospital Registration Information
• Providence Alaska Patient Pre-registration
