Patient Forms
Alaska Urgent Care
New Patient Packet - https://www.alaskamedicalclinics.com/wp-content/uploads/Registration-Form.pdf
Demographic Form - https://www.alaskamedicalclinics.com/wp-content/uploads/AUC-Patient-Demos-PDF.pdf
Billing and Payment Policy - https://www.alaskamedicalclinics.com/wp-content/uploads/AUC-BIlling-and-Payment-Policy-PDF.pdf
Medical History - https://www.alaskamedicalclinics.com/wp-content/uploads/AUC-Medica-History-PDF.pdf
Authorization to Release Medical Records - https://www.alaskamedicalclinics.com/wp-content/uploads/AUC-Authorization-to-Release-Medical-Records.pdf
Authorization to Treat a Minor - https://www.alaskamedicalclinics.com/wp-content/uploads/AUC-Authorization-to-Treat-a-Minor.pdf
Notice of Privacy Practices - https://www.alaskamedicalclinics.com/wp-content/uploads/AUC-Notice-of-Privacy-Practices-PDF.pdf
ASD Sports Physical - https://www.alaskamedicalclinics.com/wp-content/uploads/ASD-Sports-Physical-Form-1.pdf
DOT Medical Exam - https://www.alaskamedicalclinics.com/wp-content/uploads/DOT-CDL-Exam-Forms-exp.-2024.pdf
Driver Medication Form - https://www.alaskamedicalclinics.com/wp-content/uploads/CDL-Driver-Medication-Form.pdf
Insulin-Treated Diabetes - Form https://www.alaskamedicalclinics.com/wp-content/uploads/CDL-Insulin-Treated-Diabetes-Form.pdf
Vision Evaluation Report -
https://www.alaskamedicalclinics.com/wp-content/uploads/CDL-Vision-Evaluation-Report.pdf
Wasilla Medical Clinic
New Patient Packet - https://www.alaskamedicalclinics.com/wp-content/uploads/New-Patient-Packet.pdf
Demographic Form - https://www.alaskamedicalclinics.com/wp-content/uploads/WMC-Demographic-Form.pdf
Billing and Payment Policy - https://www.alaskamedicalclinics.com/wp-content/uploads/WMC-Billing-Policy.pdf
Medical History - https://www.alaskamedicalclinics.com/wp-content/uploads/WMC-Medical-History.pdf
Authorization to Release Medical Records - https://www.alaskamedicalclinics.com/wp-content/uploads/WMC-Authorization-To-Release-Medical-Records.pdf
Authorization to Treat a Minor - https://www.alaskamedicalclinics.com/wp-content/uploads/WMC-Authorization-To-Treat-A-Minor.pdf
Notice of Privacy Practices - https://www.alaskamedicalclinics.com/wp-content/uploads/WMC-Notice-of-Privacy-Consent-and-HIPAA.pdf
MSBSD Sports Physical - https://www.alaskamedicalclinics.com/wp-content/uploads/MSBSD-Sports-PE.pdf
DOT Medical Exam - https://www.alaskamedicalclinics.com/wp-content/uploads/DOT-CDL-Exam-Forms-exp.-2024.pdf
Driver Medication Form - https://www.alaskamedicalclinics.com/wp-content/uploads/CDL-Driver-Medication-Form.pdf
Insulin-Treated Diabetes Form - https://www.alaskamedicalclinics.com/wp-content/uploads/CDL-Insulin-Treated-Diabetes-Form.pdf
Vision Evaluation Report -
https://www.alaskamedicalclinics.com/wp-content/uploads/CDL-Vision-Evaluation-Report.pdf
