Fairbanks Psychiatric & Neurological Clinic, APC

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Forms

Please feel free to print our new patient forms before your appointment. This includes the HIPAA patient consent and registration. As a reminder, please also bring your insurance and ID cards to the appointment.

HIPAA Patient Consent

Patient Registration Form

Our Release of Information documents can be filled out in case any medical records need to be obtained from a previous physician, or you’d like records sent out of our office to another physician. Please be sure to fill out as much as possible, with a signature at the very bottom. If there are any questions, our medical records clerk can be contacted at 907-452-1739.

Release of Information

About Our Services

We accept most insurance plans including Tricare, Medicaid, and Medicare for neurology services. We do not accept Medicaid or Medicare for mental health services.

Sally Caldwell, LPC-S, is now accepting Tricare insurance for counseling.

All outpatient treatment, dictation and records are handled in our offices at 1919 Lathrop Street, Suite 220, Fairbanks, Alaska.

On Call Services

On call services are available after office hours by calling our main number, (907) 452-1739. We always have a physician on call during the weekdays.

Contact Us

Fairbanks Psychiatric & Neurological Clinic
1919 Lathrop Street, Suite 220
Fairbanks, Alaska 99701

Phone: (907) 452-1739
Fax: (907) 452-2384

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