Patient Information
Forms
Release of Information – These forms allows Homer Medical Center to request or send your medical records to another facility or provider. It’s important that this for be completed in full. You can fax, drop off or mail these forms to us or the facility you would like your records sent from. Contact medical records at 907-435-3051 with questions.
- Authorization-Release of Health Information
- Special Authorization-Release of Select Health Information
- Imaging Authorization-Release of Health Information
- Revocation of Authorization to Disclose
Asthma History Form – Please fill out our Pediatric Asthma an/or Allergy form prior to your appointment.
Student Health Review/Exam form – Please fill out page 1 only and bring both pages along with you to your student physical exam.
COVID-19 Treatment EUA/Fact Sheets: