Patient Information
Forms
New Patient Packet
For an online form, send TEXT ME to (907) 743-7200.
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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