ANCHORAGE SURGICAL & BARIATRIC
The Professional and Personal Care You Deserve
FORMS
You can either download, print it and bring it with you to your appointment or you can submit the forms electronically. Either option will save you valuable time when you arrive for your initial consultation.​
If you would like to view our office policies & privacy procedures please click here.
NEW PATIENT: GENERAL SURGERY
Please fill out the demographics form and health history form.
​
We also request you bring your insurance card(s), a picture ID, and any relevant medical records to your appointment.
NEW PATIENT: BARIATRIC/WEIGHT LOSS SURGERY
Please fill out the demographics form and health history form.
​
We also request you bring your insurance card(s), a picture ID, and any relevant medical records to your appointment.
NEW PATIENT: ER FOLLOW UP
If Dr. Searles saw you in the ER/Hospital and you've not been to our office yet, please fill out this form.
​
We also request you bring your insurance card(s) and a picture ID to your appointment.
TELEMEDICINE CONSENT FORM
If you are interested in a telemedicine/video appointment with Dr. Searles please fill out this form in addition to the intake packet; new patient or annual update.
ANNUAL UPDATE
If it's been longer than 6 months since we last saw you, please fill out this form.
​
We also request you bring your insurance card(s) and a picture ID to your appointment.
RELEASE OF INFORMATION TOÂ DR. SEARLES
If there are records we need to request from a provider please fill out this form.
RELEASE OF INFORMATION FROM DR. SEARLES
If there are records you or your provider want to request from us please fill out this form.