Downloadable Forms

KANA makes a number of commonly required forms available for download on the web. By downloading and completing your forms prior to your visit, you'll save time and increase our ability to serve you quickly and efficently. 

Human Resources & Employment Forms

  • KANA Job Application ~ Download PDF
    Print and complete on paper, fax or mail.
  • Provider Application ~ Download PDF
    Print and complete on paper, fax or mail.
  • Provider Application for Word ~ Download DOC
    Complete in Word and print, and fax or mail
  • VPSO Application Addendum~ Download DOC
    Print and complete on paper, fax or mail. Requires notarization and signatures and is a required component of a VPSO Job Application.

Medical Forms

  • Notice of Privacy Practices ~ Download DOC
     
  • Authorization for Release of Information HIPAA ~ Download DOC
    Print and complete on paper. Completed form may be faxed to the confidential fax number (907) 486-9897 with the originals to be delivered in the mail or in person.
  • Denali KidCare Application ~ Download PDF

Community Development Forms

  • Kodiak Area Native Association Temporary Assistance for Needy Families (TANF) Application ~ Download DOC
  • Kodiak Area Native Association Heating Assistance Aplication ~Download DOC   

Contract Health Forms

  • ANMC Travel letter for beneficeries going out of state who may require Emergent Medical Services ~ Download PDF
  • ANMC Student letter for benefiveries who are going out of state to continue their education ~ Download PDF

WIA, Scholarship and Childcare Application Forms

Women, Infant, & Children Forms

Download and complete forms. Fax them to 907-486-9898, drop them off at the KANA office, or mail them to KANA 3449 Rezanof Drive East, Kodiak, AK 99615.

 

3449 E Rezanof Dr, Kodiak, Alaska 99615  ~  Phone: 907.486.9800  ~  Fax: 907.486.9898