What to Bring to Your Appointment

• 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:

• 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.

• Medical release form (PDF)

Insurance and Payment Information

Valley Urology is a provider for Medicare, Medicaid, and most major insurance plans. As a courtesy, we provide insurance billing. We 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
• Providence Alaska Medical Center
• Healthsouth Alaska Surgery Center

Privacy Practices

Valley Urology wishes to present 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.

• Notice of Privacy Practices
• Acknowledgment form (PDF)
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