Forms can be filled out and emailed back to support@apgkids.com or faxed to 907-563-1170.
*Note- if you are doing click and fill forms, you need to “print as a PDF” to save your entries. If you enter data and try to send it back, it often comes through blank. If you need assistance, please call our office.
Registration Forms:
Patient Registration Form (click and fill- PDF Download- 473kb)
Patient Portal Consent (click and fill- PDF Download- 129kb)
Financial Policy Form (click and fill- PDF Download- 356kb)
Consent for Care Form (click and fill- PDF Download- 351kb)
Over 18 Consent to Discuss (click and fill- PDF Download- 164kb)
Release of Information Form (click and fill- PDF Download- 226kb)
COVID Vaccination Forms:
COVID-19 Prevaccination Checklist ENGLISH (PDF Download- 312kb)
COVID-19 Prevaccination Checklist SPANISH (PDF Download- 235kb)
ADHD Screening Forms:
NICHQ Parent Informant ENGLISH (click and fill- PDF Download- 5028kb)
NICHQ Parent Informant SPANISH (PDF Download- 326kb)
NICHQ Teacher Informant (click and fill- PDF Download- 3503kb)