New Patient Information
If you are an American Indian/Alaska Native you may be eligible to receive our services at United Indian Health Services. To qualify for this benefit, you must be able to provide us with documents verifying that you are American Indian.
The following is a list of documentation which is required to receive our services and in some cases needed to continue to receive care or medication at United Indian Health Services.
PRIOR to registration, we need the following
- Any insurance cards (if applicable)
- Tribal enrollment card or letter with roll/registration number from a Federally Recognized Tribe
- California Indian listed on the California Judgment Roll
- Certificate of Degree of Indian Blood (CDIB) from the Bureau of Indian Affairs (BIA)
- Minor children need a Certified Birth Certificate or other appropriate document providing a link to an Eligible parent or guardian. Clients have 6 months to submit a Birth Certificate for newborn babies
- Signed ‘Notice of Privacy Practices’ Form
- Family Intake Screening Form
Non-Indian Spouses or Domestic Partners of an Eligible Indian Beneficiary are currently eligible for services but they must meet the following requirements:
- Provide a Certified Marriage or Certified Domestic Partner Certificate;
- Live in the same household as their spouse/domestic partner;
- Reside within the UIHS Service Area; and
- Maintain valid medical insurance coverage.
If you have not already filled-out a Family Intake Screening Form, please click HERE to access the form and bring it with you to your first appointment.
If you have any questions regarding documentation, please contact us at:
Humboldt clients: (707) 825-4090
Del Norte clients: (707) 465-2960