Patient Information
Forms
Please Note
We are only able to send digital forms to patients who have had a visit within the past year or have an upcoming appointment scheduled with us.
New patients must call 907-743-7200 to schedule an appointment with ANHC before receiving forms via text. New patients also can complete PDF versions of the forms or pick up hard copies from our office.
New Patient Packet
New Patient Packet PDF (English) (Rev. 10/2024)
New Patient Packet PDF (Spanish) (Rev. 10/2024)
Sliding Fee Discount Application
For an online form, send TEXT ME to 907-743-7200.
Sliding Fee Discount Application PDF (English) (Rev. 2/2024)
Sliding Fee Discount Application PDF (Spanish) (Rev. 7/2024)
Dental Health History
Dental Health History (English) (Rev. 9/2023)
Dental Health History (Spanish) (Rev. 9/2023)
PERSONAL HEALTH INFORMATION DISCLOSURE agreement
For an online form, send TEXT ME to 907-743-7200.
Request an Appointment
To request an appointment, you can call or send TEXT ME to 907-743-7200.
Request a refill of an existing Prescription
If your prescription is at an outside pharmacy like Fred Meyer, Carrs, Walgreens, please contact that pharmacy directly.
Existing ANHC prescriptions only: Online prescription refill request form
You may also send an email to prescriptions@anhc.org or call our 24/7 refill line 907-743-7208.
Request a new Prescription
To contact your ANHC care team to request a new prescription, send TEXT ME to 907-743-7200.
Contact my Care Team
To contact your ANHC care team, send TEXT ME to 907-743-7200.
Request my Medical Records
To request that your medical records be sent to you, send TEXT ME to 907-743-7200.
Looking for your vaccine records? Download the Docket app for easy access.
Apple users: Download Docket from the App Store.
Android users: Download Docket from Google Play.
Request a Release of Information
Request that your medical records be sent to ANHC, request that ANHC send your medical records to another provider, or request a mutual exchange of information.
For an online form, send TEXT ME to 907-743-7200.
Advanced Authorization for Release of Information Request Form PDF (English) (Rev. 9/2024)
Advanced Authorization for Release of Information Request Form PDF (Spanish) (Rev. 9/2024)
Make a Care Request
Request a different provider or make a complaint about the care you received at ANHC.
For an online form, send TEXT ME to 907-743-7200.
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