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What to Bring to Your Appointment |
Patient Forms | Release of Records
Insurance & Payment Information | Hospital Affiliations | Privacy Practices
What to Bring to Your Appointment
Please arrive early so that we can complete your initial paperwork. Also, please bring the following:
- Picture ID required to meet Federal Government Identify Theft Prevention Requirements as of May 1, 2009
- Your insurance card
- Physician referral forms if required by insurance
- A list of current prescriptions and/or over-the-counter medications you are taking, including dose and frequency
- Pertinent information about your medical and surgical history
- Any recent x-rays or appropriate records you may have
- List of allergies
- Completed patient forms
Patient Forms
For your convenience, please print and complete the following forms before your office visit:
[PDF Help]
- Medical history form (PDF)
- Patient information form (PDF)
- Patient consent form (PDF)
Release of Records
If you need to have records sent to our practice, please print and complete the following form and forward it to your physicians prior to your appointment with us. If you have any questions, please contact us.
[PDF Help]
- Medical release form (PDF)
Insurance and Payment Information
Valley Urology is a preferred provider for Premera Blue Cross, Medicare, and Medicaid. We accept most major insurance plans. As a courtesy, we provide insurance billing; however, we do request payment at the time of service for any co-payments and/or deductibles that are due. When necessary, our staff will work closely with patients who require a payment plan.
If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company.
Hospital Affiliations
Dr. Lund has privileges at the following medical facilities:
- Mat-Su Regional Medical Center (907) 861-6000
- Alaska Regional Medical Center (907) 276-1131
- Providence Alaska Medical Center (907) 562-2211
- Healthsouth Alaska Surgery Center (907) 550-6100
Privacy Practices
Valley Urology provides a document outlining privacy practices. This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. We have also provided an acknowledgement form of the privacy notice.
