Start Now2018-10-03T08:36:46+00:00

Get real results that last

real weight loss results alaska premier health

Book your free weight loss consultation now! Simply complete this form and we’ll be in touch to schedule very soon.

Save time by completing forms in advance

1. Read

Please read our statement on patient privacy. You do not need to print it and bring it with you to your appointment.

HIPAA Privacy Policy

2. Fill Out

You will need a Patient ID and a password, which will be given to you when you schedule your appointment.

Medical History Form

3. Download

Please download and print this patient registration form. Fill it out and bring it with you to your appointment.

Patient Registration Form


We will bill primary insurance for patients whose insurance covers weight management. As of January 2018, Federal Blue Cross, ASEA – Local 52, IBEW, NEA/Public Education Trust, Premera (select groups), Aetna (select groups), United Healthcare (select groups), CIGNA (select groups), Meritain (select groups), and others HAVE provided coverage. Not all employers who provide insurance include obesity as a covered diagnosis. Insurance quotes are not a guarantee of coverage.

Coded receipts are provided for insurance reimbursement if you wish to bill your insurance yourself. Download our helpful guide to determining your insurance coverage.

Required Diagnostic Tests

To get started, we require a panel of diagnostic tests to establish baseline lab data as well as to highlight any abnormalities. We will accept any of these tests done by outside providers as long as the results are from within 90 days of your initial appointment:

  • CBC (Complete Blood Chemistry)
  • CMP (Comprehensive Metabolic Panel)
  • Lipids
  • HgA1c (Hemoglobin A1c)
  • TSH (Thyroid Stimulating Hormone)
  • Uric Acid
  • Urinalysis (Screening for glucose and protein)
  • EKG