(907) 334-6788

Tim Kavanaugh, M.D. Brian Carino, M.D.

Patient Information & Forms

Forms
ABJ understands that our patients want to have their office visit be as smooth as possible. To help facilitate this process, we have provided our patient forms online for you to download and complete before your visit.  This saves you the effort of filling out the form after you get to the office.

Listed below are the patient forms we have you fill out when you come for your visit. Simply scroll through the list to find the form you need, then click on the link to download the form and print it.

Patient Information Form
Patient Health History Form
Financial Policy
Knee Form
Medical Records Release & Authorization
Follow Up Medical Questionnaire


New Patients
If you have not been in our office or seen one of the physicians, you may want to facilitate the collection of your personal information by downloading and completing the appropriate forms. All patients will need to fill out the Patient Information Form and the Patient History Form.  If you have a knee problem,  you will need a Knee Form. 

Please give the completed forms along with your photo ID and insurance cards to the receptionist when you arrive at the office. Patients will need to bring all prior medical records pertaining to the current injury, and any prior x-rays, MRI, CT scans, or bone scans, if any.

Payment Policy /
Co-payments, deductibles, and co-insurance are determined by your insurance plan and represent an agreement between you and your insurance company.  If the deductible and / or co-insurance amounts are NOT known, payment will be expected IN-FULL at the time of service.  Generally, most plans are covered at 80%.  We request 20% of your visit cost be paid at the time of service.  Any additional patient responsibility will be statement billed.

Alaska Bone and Joint Institute accepts cash, check, MasterCard and Visa for your convenience.

Medicare and Medicaid
Medicaid patients will need to bring a copy of their current Medicaid card for each visit.  A three dollar co-payment is required, and must be paid at the time of service. Both of our physicians accept Medicare.


Worker’s Compensation
If you are being treated for a Worker’s Compensation injury, please bring your claim number and the name and address of the employer’s Worker’s Compensation Carrier at the time of service.



Inpatient and Outpatient Procedures
All procedures will be pre-authorized by our office. You will need to contact your insurance company if you would like to know how much will be paid on your surgery and for any additional information regarding your policy provisions.