• CALL TODAY
    907-522-1341
  • INDEPENDENCE PARK MEDICAL SERVICES
    Comprehensive Family Care since 1984
Patient Portal
  • Home
  • About Us
  • Specialties
    • Family Health Care
    • Obstetrics & Gynecology
    • Pediatric Endocrinology
    • Aesthetic Treatments
    • Chronic Pelvic Pain
    • FAA Physicals and Medical Certifications
  • Patient Resources
  • Patient Portal
  • COVID Procedures
  • Telehealth Visits
  • Payments
Menu
  • Home
  • About Us
  • Specialties
    • Family Health Care
    • Obstetrics & Gynecology
    • Pediatric Endocrinology
    • Aesthetic Treatments
    • Chronic Pelvic Pain
    • FAA Physicals and Medical Certifications
  • Patient Resources
  • Patient Portal
  • COVID Procedures
  • Telehealth Visits
  • Payments
  • Home
  • About Us
  • Specialties
    • Family Health Care
    • Obstetrics & Gynecology
    • Pediatric Endocrinology
    • Aesthetic Treatments
    • Chronic Pelvic Pain
    • FAA Physicals and Medical Certifications
  • Patient Resources
  • Patient Portal
  • COVID Procedures
  • Telehealth Visits
  • Payments
Menu
  • Home
  • About Us
  • Specialties
    • Family Health Care
    • Obstetrics & Gynecology
    • Pediatric Endocrinology
    • Aesthetic Treatments
    • Chronic Pelvic Pain
    • FAA Physicals and Medical Certifications
  • Patient Resources
  • Patient Portal
  • COVID Procedures
  • Telehealth Visits
  • Payments

EASILY ACCESSIBLE NEW PATIENT FORMS To Prepare Before Your Visit

Here you can download, print and fill out any relevant files for your upcoming visit so you don’t need to rush to fill out paperwork in our office.

New Patient Forms

  • New Patient Packet
  • Registration Form
  • Financial Policy
  • HIPPA: Notice of Privacy Practices Policy
  • HIPPA: NPP Acknowledgement
  • Aesthetic Treatment Instructions

Endocrinology Forms

  • Welcome Letter
  • New Patient Packet
  • Returning Patient Form
  • Referral Form

Other Clinic Forms

  • COVID-19 Patient Survey
  • Notice of Nondiscrimination Policy
  • Prescription Refills Policy
  • Controlled Substances Policy
  • Notice of Language Assistance Services
  • Health Care Transparency Ordinance

Medical History Forms

  • Adult Health History Form
  • Female Health History Form
  • Pediatric Health History Form

Release Forms

  • Personal Health Information Release (PHI)
  • Medical Records Release
  • Permission to treat a Minor
  • Botox Consent

Price Transparency Forms

  • Good Faith Estimate
  • Price Transparency Disclosure
  • PPDR Website Privacy Policy
  • No Surprise Act: Complaint Privacy Policy

CALL (907) 522-1341 IF YOU HAVE ANY QUESTIONS

Need access to high-quality health care? Fill out the following form to schedule an appointment or ask questions. We can't wait to welcome you to IPMS!

Our Hours

Monday – Friday: 8am – 5pm
Closed for lunch from 12 – 1pm

We know Alaskans love to Live, Work, and Play.

 

We are here to help you return to health and stay healthy so that you can get back to doing all that you love. Our business hours allow you to come in when you need care.

Quick Links

  • COVID Procedures
  • Telehealth Visits
  • About Us
  • Patient Resources
  • Patient Portal
  • Blog
  • Contact Us
  • Specialties
  • Family Health Care
  • Obstetrics & Gynecology
  • Chronic Pelvic Pain
  • Pediatric Endocrinology

Contact Us

9500 Independence Drive
Suite 900
Anchorage, AK 99507
  • 907-522-1341
  • 907-522-1343

© 2021 – INDEPENDENCE PARK MEDICAL SERVICES

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