If you are experiencing a medical emergency, please call 9-1-1.
To contact the Indian Health Service Alcohol and Substance Abuse Program staff ONLY about 1.the ASAP program or 2. this website, please fill out the form below completely.
DO NOT USE THIS FORM FOR MEDICAL HELP
This form is NOT to be used to ask about or get health care.
Please visit the IHS FIND HEALTHCARE page to find healthcare and healthcare professionals who can help you or someone else.
DO NOT enter any personal information into this form other than name and email address, or use for any inquiry unrelated to the IHS Alcohol and Substance Abuse Program (ASAP) or this website. Please allow up to 10 business days for a response to your inquiry.
To protect you, your family's, or your patient's privacy, please DO NOT include any Personally Identifiable Information (PII) or Protected Health Information (PHI) on this form.
Examples of PII and PHI are: personal phone number(s), personal address, individual health condition(s), Social Security number (SSN), date of birth (DOB), patient name (if not your own), and patient registration number.