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 new patient form, patient authorized use and disclosure form and notice of privacy practices.
Documents:
The PDF forms below were created for your convenience and require a copy of Adobe Reader software installed on your computer. To download a free copy just click here.
Interactive PDF 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)
• 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
