Registration/HIPAA Form
Release of Information (ROI)
EPS COVID Authorization
EPS Authorization
The Release of Information (ROI) form is required to obtain your medical records. Your completed form may be turned in at the front desk, faxed to (907) 790-3111, or emailed to reception@juneauurgentcare.com. Fees: Please be aware that fees may apply to records requests of over 10 pages. No fee applies when requesting to have your records sent to your primary care physician for continuation of care. We allow 10 pages for free, and then every additional page is $0.88.
*Our clinic policy requires that we collect payment before sending records.*
Please note: It may take a few moments to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat Reader for free by clicking on the icon below.
If you would like to preregister before arriving at the clinic, you may fill out the PDF form below, and return it via fax or email.
Email: Reception@juneauurgentcare.com
Fax: (907) 790-3111
If you have any inquiries regarding your bill please call (866) 683-9798.
There are so many things to do and see in and around Juneau! Here are some that we recommend you do not miss:
- The Mendenhall Glacier
- The Mount Roberts Tramway
- Eaglecrest Ski Resort
- Auke Lake
- Glacier Gardens Rainforest Adventure
Remote Travel Safety Guide
Living with Wildlife
Safety in Bear Country
Physical and Mental Preparation
First Aid and Travel Safety
Water Treatment
Minimum Impact Camping & Fire Awareness
How long will the wait be for a walk-in?
There is never a clear-cut answer to this question, since the wait time is dependent on our patient flow, which is never predictable. Since appointments take precedence over walk-ins, we encourage patients to schedule an appointment whenever possible. Please note that we only have one doctor on staff at a time and we make our best efforts to ensure that you receive excellent patient care at the best of our abilities. If there is a medical emergency, it takes priority immediately. We are pleased to offer our patients a clean, comfortable, kid-friendly waiting room, and our patients tell us that it’s a welcome alternative to the hustle and bustle and wait times of a hospital Emergency Room.
How soon can I have my lab results?
Most lab results are available within 3-7 days; however, some tests may take longer. When we receive lab results, we will contact you via the number listed on your registration, so please be sure to let us know if your contact information needs to be updated.
You may also receive results online from Quest Diagnostics, by creating your own login to view your results in real time. Please see the medical assistant or the front desk personnel for more information about online access to lab results.
How do I obtain my medical records from Juneau Urgent & Family Care?
You will need to fill out a Release of Information (ROI) form to obtain your medical records. You may request this form from the medical assistant in the office, or you may print or download this form directly from our website by visiting the PATIENT RESOURCES tab.
Your completed form may be turned in at the front desk, faxed to (907) 790-3111, or emailed to reception@juneauurgentcare.com.
Fees: Please be aware that fees may apply to records requests of over 10 pages. No fee applies when requesting to have your records sent to your primary care physician for continuation of care. We allow 10 pages for free and then every additional page is $0.88 apiece. Our clinic policy requires that we collect payment before sending records.
At Juneau Urgent & Family Care, we welcome patients of all ages, and walk-ins are always welcome and accommodated. Our knowledgeable and friendly providers will get you ready to return to your Alaska adventure as soon as possible. If you prefer, you may register online for an Urgent Care appointment, or call (907) 790-4111 to speak with a member of our staff.
Kelly Griffn, FNP:
In-Clinic Schedule: 2024
Jan. 18- Jan. 31 | Feb. 15- Mar. 1 | Mar. 14- Mar. 27 | Apr. 11- Apr. 24 | May 9- May 22| June 6- June 19 | July 5- July 17 | Aug. 1- Aug. 14 | Aug. 29- Sept. 11| Sept. 19- Oct. 2 | Oct. 17- Oct. 23| Nov. 7- Nov. 20| Dec. 5- Dec. 18
Wendy Smith, PA-C:
Jan. 4- Jan. 17 | Feb.1- Feb. 14 | Mar. 2- Mar. 13 | Mar. 28- Apr. 10 | Apr. 25- May 8 | May 23- June 5 |June 20 -July 3 | July 18 - July 31 | Aug. 15- Aug 28 | Sept. 12- Sept. 18 | Oct. 3-Oct. 16 | Oct. 24- Nov. 6 | Nov. 21- Dec 4 | Dec 19- Dec. 31
Our Price Transparency
Juneau Urgent & Family Care is a non-hospital affliated health care provider. We provide our fee scheulde in order to empower patients to make informed decisions about their health care options by ensuring accessible medical pricing information.
Pricing Lists
The pricing is listed by the Current Procedural Terminology (CPT) code used by insurance companies. The lists are in a spreadsheet format.
PLEASE NOTE: The pricing lists below show charges prior to contract negotiations with individual insurance providers. They may be useful for comparing pricing with other practices or providers, but they DO NOT indicate actual costs to patients.
| Top Procedure Code used at Practice | ||
| Code | Description | Price |
| 1014 | DOT PHYSICAL | $ 245.00 |
| 10060 | DRAINAGE OF SKIN ABSCESS SIMPLE/SINGLE | $ 363.00 |
| 10061 | DRAINAGE OF SKIN ABSCESS COMPLICATED/MULTIPLE | $ 503.00 |
| 10080 | INCISION & DRAINAGE PILONIDAL CYST SIMPLE | $ 511.00 |
| 10081 | INCISION and DRAINAGE PILONIDAL CYST COMPLICATED | $ 793.00 |
| 11104 | PUNCH BX SKIN SINGLE LESION | $ 132.00 |
| 11105 | PUNCH BX SKIN EA SEP/ADDITIONAL LESION | $ 79.00 |
| 11740 | EVACUATION SUBUNGUAL HEMATOMA | $ 126.00 |
| 12001 | REPAIR SUPERFICIAL WOUND(S) | $ 514.00 |
| 12041 | LAYER CLOSURE OF WOUND(S) | $ 707.00 |
| 12051 | INTMD WND REPAIR FACE/MM | $ 723.00 |
| 17110 | DESTRUCT B9 LESION 1-14 | $ 252.00 |
| 36415 | ROUTINE VENIPUNCTURE | $ 41.00 |
| 71046 | RADIOLOGIC EXAM, CHEST; 2 VIEWS | $ 195.00 |
| 73030 | RADIOLOGIC EXAMINATION, SHOULDER; C | $ 205.00 |
| 73110 | RADIOLOGIC EXAMINATION, WRIST; COMP | $ 199.00 |
| 73562 | RADIOLOGIC EXAMINATION, KNEE; 3 VIE | $ 235.00 |
| 73610 | RADIOLOGIC EXAMINATION, ANKLE; COMP | $ 216.00 |
| 73630 | RADIOLOGIC EXAMINATION, FOOT; COMPL | $ 205.00 |
| 72052 | RADIOLOGIC EXAMINATION, SPINE, CERV | $ 268.00 |
| 72080 | RADIOLOGIC EXAMINATION, SPINE; THOR | $ 217.00 |
| 72120 | RADIOLOGIC EXAMINATION, SPINE, LUMB | $ 212.00 |
| 80307 | Drug Screen | $ 125.00 |
| 81003 | URINALYSIS AUTO W/O SCOPE | $ 31.00 |
| 81025 | URINE PREGNANCY TEST | $ 47.00 |
| 86480 | TB TEST CELL IMMUN MEASURE | $ 396.00 |
| 86580 | TB INTRADERMAL TEST | $ 103.00 |
| 86703 QW | HIV-1/HIV-2, SINGLE ASSAY RAPID TES | $ 45.00 |
| 86780 | SYPHILIS TEST ANTIBODY TREPONEMA PALLIDUM | $ 40.00 |
| 87428 | SARSCOV and INF VIR AandB AG IA | $ 150.00 |
| 87491 | CHYLMD TRACH DNA AMP PROBE | $ 75.00 |
| 87591 | N.GONORRHOEAE DNA AMP PROB | $ 75.00 |
| 87635 | SARS-COV-2 COVID-19 AMP PRB NAAT | $ 75.00 |
| 87880 | STREP A ASSAY W/OPTIC | $ 66.00 |
| 88999 | MA Visit/ Non Provider Vist EPS | $ 94.00 |
| 90471 | IMMUNIZATION ADMIN | $ 57.00 |
| 90472 | IMMUNIZATION ADMIN EACH ADD | $ 41.00 |
| 90632 | HEP A VACCINE ADULT IM | $ 165.00 |
| 90715 | TDAP VACCINE GT7 IM | $ 110.00 |
| 90746 | HEPATITIS B VACCINE, ADULT DOSAGE, | $ 159.00 |
| 92551 | PURE TONE HEARING TEST AIR | $ 74.00 |
| 94014 | SPIROMETRY/PULMONARY FUNCTION TEST | $ 146.00 |
| 96127 | BRIEF EMOTIONAL/BEHAV ASSMT | $ 25.00 |
| 96372 | THER/PROPH/DIAG INJ, SC/IM | $ 64.00 |
| 99000 | SPECIMEN HANDLING OFFICE-LAB | $ 32.00 |
| 99172 | OCULAR FUNCTION SCREEN | $ 70.00 |
| 99173 | VISUAL ACUITY SCREEN | $ 47.00 |
| 99199 | Doctor Not Required Visit | $ 94.00 |
| 99202 | OFFICE VISIT NEW STRAIGHTFORWARD | $ 215.00 |
| 99203 | OFFICE VISIT NEW LOW COMPLEXITY | $ 335.00 |
| 99204 | OFFICE VISIT NEW MODERATE COMPLEXITY | $ 505.00 |
| 99205 | OFFICE VISIT NEW HIGH COMPLEXITY | $ 670.00 |
| 99212 | OFFICE VISIT EST STRAIGHTFORWARD | $ 165.00 |
| 99213 | OFFICE VISIT EST LOW COMPLEXITY | $ 270.00 |
| 99214 | OFFICE VISIT EST MODERATE COMPLEXITY | $ 390.00 |
| 99215 | OFFICE VISIT EST HIGH COMPLEXITY | $ 545.00 |
| 99393 | PREV VISIT, EST, AGE 5-11 | $ 214.00 |
| 99394 | PREV VISIT, EST, AGE 12-17 | $ 231.00 |
| 99395 | PREV VISIT, EST, AGE 18-39 | $ 268.00 |
| 99396 | PREV VISIT, EST, AGE 40-64 | $ 297.00 |
| 99429 | PHYSICAL EVALUATION WITH DOCTOR | $ 185.00 |
| 99455 | MMPE | $ 205.00 |
| 99499 | Flex and Lift | $ 85.00 |
| 82075 | ASSAY OF BREATH ETHANOL | $ 98.00 |
| 99070FQ | OSHA MEDICAL Questionaire | $ 75.00 |
| 99070FT | Respiratory Fit Test | $ 75.00 |
| J0696 | ROCEPHIN 250 MG | $ 26.00 |
| J1030 | INJ METHYLPRDNISOLONE ACTAT 40 MG | $ 50.00 |
