Resources

Urban Inter-Tribal Center wants to ensure you stay safe and healthy during the COVID-19 pandemic. Please see below for some information and resources includes online application forms helpful during these difficult times. Please carefully read the instructions while filling the forms and submit.

Personal Health Record (PHR)

The Indian Health Sevice (IHS) PHR is a secured web-based application where patients can interact with their healthcare information. For more details watch the video link

COVID -19 PANDEMIC

Testing Questionnaire - Click this link

Vaccination Registration and pre-screening - Click this link

MEDICAL RECORDS

The request for Information from UITCT: Please fill out this form to request personal medical information be sent from UITCT to an outside individual, facility, or organization - Click this link

The request for Information to UITCT: Please fill out this form to allow UITCT to request your personal medical information from an outside facility - Click this link

DENTAL

Please fill out the below form before your visit to the dental clinic

Dental Consent: Click this link to fill the form

Dental Emergency: Click this link to fill the form

Dental Medical History: Click this link to fill the form

EMPLOYMENT & TRAINING

WIOA Application: Click this link to fill the form

WIOA Intake & Eligibility: Click this link to fill the form

WIOA I-9: Click this link to fill the form

WIOA Letter of Residency: Click this link to fill the form

COVID-19 Vaccination
You are invited to register for our COVID-19 Vaccination
X
Scroll to Top