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Registration Form

This form notifies the Alaska Medical Library of your interest in using our service.

Incomplete forms will hold up delivery of articles.

**Items in Red are Required**



Hospital/clinic employees must provide their work email address to verify affiliation
Physicians: enter affiliated hospital(s)
(PIN to access locked resources)
Choose an easy-to-remember number such as a birthdate or anniversary (mmddyy)
MD    Nurse    DO    DVM
NP    PA    Dentist
Other
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Mental Health
Legal    International
Payable to Alaska Medical Library (minimum of $100 U.S.) Required only for document delivery and literature searches not covered by your institution.



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