Patient Resources
Patient Resources
Appointment Information
Your experience at our clinic is a vital part of the In-Take process. Please review the items below. Print out the New Patient Forms to fill out and bring to your first appointment.
- What to wear – Dress comfortably for your appointment. For example:
- A pair of gym shorts for knee, hip, and low back exams.
- A tank top or sleeveless shirt for shoulder and neck exams.
- Bring your insurance card, photo ID, and completed New Patient Forms.
- Please arrive 15 minutes early – Allows time to process the paperwork needed at the time of your appointment.
- Any questions, concerns, or to reschedule your appointment, please call us at 907-364-2663
Patient Forms
Orthopedic Clinic
Dr. Bursell
Outpatient Musculoskeletal/ Neurological Therapy
Physical Therapy & Massage Therapy
Print and bring these forms PLUS the Functional Outcome Measure to your first appointment.
Functional Outcome Measures
Pick the form that corresponds the best to your affected body part or area to be treated.
Telehealth Rehab Consent
Please READ/SIGN prior to your first telehealth rehab appointment:
Parental Consent
Release of Medical Records
Please fill out and return to our clinic to get your medical records.
Please fill out and return to our clinic to get your medical records.
Insurance
JBJC accepts, and bills as a courtesy, all major insurances including:
- Blue Cross: Premera Blue Cross Blue Shield of Alaska, Federal and all other Blue Cross Blue Shield plans.
- Aetna
- Medicaid
- Medicare
- TRICARE and CHAMPVA
- VA
- Out of State workman’s comp such as WA L&I.
We accept most private insurance plans, please call us if you have questions.
Overall, we’d prefer you to call us if you have ANY questions about insurance and our services.