(907) 312-5315

Patient Forms

To save time when you meet with one of our dentists and team, we have listed our patient forms online. Prior to your appointment at Alcan Family Dental, 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 907-312-5315. One of our friendly team members will gladly help you.

Adult New Patient Forms

Download Form

Child New Patient Forms

Download Form

Office Policy & Payment Agreement Form

Download Form

Acknowledgement of Privacy Practices

Download Form

Consent of Record Release

Download Form

HIPPA Notice

Download Form

IV Sedation Pre-Op Form

Download Form

Use of Dental Insurance & Payment Agreement

Download Form