Patient Info for New Patients

Please print, fill out, and bring these forms with you to your appointment.

New Patient Forms (Form will open in a new window.)
HIPAA Form (Form will open in a new window.)

Our promise to you!

At Ersland Family Dental we have always implemented state of the art sterilization procedures and followed all guidelines set by the OSHA for all office procedures. Our goal is to be the Anchorage Dentist that utilizes the most current guidelines and new scientific information to continue to stay abreast of infection control procedures.

Insurance Policy

As a part of our overall service, we will prepare and submit your insurance for you as a professional courtesy. Although our staff is specially trained to assist you in maximizing your dental insurance and filing your claims for you as a courtesy.

However, your dental plan is designed to share in your dental care costs, so your insurance may not cover the total cost of your bill. There are many ways in which dental plans are designed and reimbursement levels are determined. It is important for you to review your plan and utilize it to the fullest.

We are insurance friendly and Preferred Providers for Aetna, Cigna, Delta Dental, United Concordia, and Premera. Also Accepting Denali Kid Care.

Financial Options

  • We accept all major credit cards (3% courtesy for payment in full)
  • We accept check and cash payments (5% courtesy for payment in full )
  • Interest free financing with Care Credit

Payment for services will be reviewed with you prior to each appointment.
Full responsibility for payment of services rendered belongs to the patient or parent/guardian. We request all account balance be paid in full unless other arrangements have been made.


2525 Gambell Street Ste. 304
Anchorage, Alaska
Phone: 907-276-1621
Fax: 907-279-0562

Need directions?
Click here for online map

Office Hours for appointments:

Monday - Friday
8:00AM to 5:00PM