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This section should contain all of the documents and forms you may need for our office. Please Contact Us if you don't find what you're looking for. To view these documents you must have the Adobe® Reader® software installed on your computer. To get a free version of this software from Adobe, click here. Fill out the form and print when done, it will not save changes. Release of Information - Initial each box that applies and please fill out one form for each person/facility receiving records. Please note, though we will try to respond to your request as soon as possible, it may take up to 30 days to respond to a release of information request.
Transfer or Switch Providers - If you would like to switch to a different provider, you can Contact Us with your request, or fill out this form. This form can be brought in to us, mailed, or faxed (907-352-3373). New Client/Patient Paperwork: Individual Rights and Responsibilities Medical Questions (Primary Care only) Review of Systems (Primary Care only) Client Status Review (Behavioral Health only)
Additional Client/Patient Paperwork:
Below are some websites with forms for different physicals. Please bring any forms for physicals pre-filled to your, or your child's, appointment. CDL Physicals: http://www.fmcsa.dot.gov/documents/safetyprograms/Medical-Report.pdf Boy Scout Physicals: http://www.scouting.org/scoutsource/HealthandSafety/ahmr.aspx Mat-Su School Physicals: http://www.matsuk12.us/matsu/lib/matsu/_shared/MSBSD_Forms/Student%20Support%20Services/StudentPhysicalExaminationForm.pdf Mat-Su Sport Physicals: http://www.matsuk12.us/matsu/lib/matsu/_shared/MSBSD_Forms/Education%20and%20Instruction/AthleticParticipationForm.pdf Below are Summary Documents for current and previous employees enrolled in the Mat-Su Health Services 403(b) program: Summary of Material Modifications |
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