Patient Forms

We at IHC want to take a moment to welcome you to our practice. We want you to know that we appreciate the opportunity to take care of you and your family. Thank you for selecting us as your patient centered home and we look forward to serving you.

Registration forms to complete

Please complete these forms and bring them into our Central Registration Department located near our Medical department front desk prior to your appointment.

• Adult Registration Packet
• Minor Registration Packet

Information to Bring

Bring this information with you to our Central Registration Department along with your completed registration packet.

• Proof of Indian (BIA Letter, Tribal ID Card or Tribal Letter)
• Proof of Residency (Current utility bill, DMV Registration, or rental/lease agreement)
• Insurance card(s)
• Copy of Social Security Card
• Marriage Certificate (If Non-Indian Spouse)
• Birth Certificate (If Child/Minor)
• Proof of Income (If Uninsured)

• Patient Rights and Responsibilities
• IHC Notice of Privacy Practice
• Dental Materials Fact Sheet
• Please click here Advance Directive Information