Patient Forms

To save time when you meet with Dr. Mark Birmingham, our dentists and team have listed our patient forms online. Prior to your appointment at Alcan Dental Group, you can download and submit your forms from the comfort of your own home. If you have questions about our forms, or would like to schedule your dental appointment in Anchorage, Alaska, call our office at 907-562-4774. One of our friendly team members will gladly help you.

Health History Form

Adult Intake Form

Child Intake Form

Office Policy & Payment Agreement Form

Acknowledgement of Privacy Practices

Consent of Record Release

HIPPA Notice

IV Sedation Pre-Op Form

Use of Dental Insurance & Payment Agreement