Alaska Foot & Ankle Specialists: Patient Information and Forms

Alaska Foot & 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 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 questions 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)

External Web Links:
• Alaska Surgery Center Patient Online Pre-Registration website

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