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Indian Health Service The Federal Health Program for American Indians and Alaska Natives

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Patient Information

First Visit - To make your first visit with us go as smoothly as possible these are some of things we will need.

A parent or legal guardian must be present at any appointment for children under 18. Please plan to bring the following:

  • Legal papers for temporary or permanent guardianship
  • The patient's Certificate of Indian Blood (CIB) or the parent's CIB if the child is under 18.
  • Social Security Card
  • Picture ID
  • Private insurance cards or Medicaid cards
  • List of current medications including over-the-counter
  • Medical History Form (Please print, SHOULD NOT be signed until witnessed by the staff upon check in)

Medical History Form

Print this form fill it out and bring with you to your appointment.

The Medical History Form [PDF - 28 KB) SHOULD NOT be signed until witnessed by the staff upon check in.