U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
 Medical and
Professional
Programs

 Desert Visions Youth Wellness Center
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Forms

Here you can printout a copy of our intake packet. All necessary forms and supporting documents must be completely filled out and necessary forms must be signed by a parent or legal guardian. If you have any questions or need help filling out forms. Please contact Terry McDowell at 1-888-431-4096 ext. 222.

Please fax all completed intake forms to fax number 1-520-562-3416 for a prompt response

Please click on link to download intake packet. [PDF-270KB]

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Indian Health Service (HQ) - The Reyes Building, 801 Thompson Avenue, Ste. 400 - Rockville, MD 20852