We are currently accepting new patients.

ESTABLISHED PATIENTS

Please arrive 15 minutes early to check in.

NEW ADULT PATIENTS

Thank you for choosing Kickapoo Tribal Health Center for your Health/Dental Care. Please arrive 1 hour prior to your scheduled appointment to allow us adequate time to establish your chart. When you arrive, you will need to fill out our registration forms. 

WHAT TO BRING

We will need the following original documents only for scanning at the time of your first visit. 

  • Current State Photo ID/Driver’s License
  • Social Security Card
  • U.S. Federally Recognized Tribal Membership/Citizenship card OR Certificate Degree of Indian Blood (CDIB)
  • Insurance Cards (Private Insurance, Medicare or Medicaid)
  • Current Proof of Residency (For patients who reside within the Kickapoo Contract Health Service boundaries, Proof of Residence includes utility bill, pay stub, lease/rental agreement or mortgage statement w/current address and current month)
NEW MINOR PATIENTS

Thank you for choosing Kickapoo Tribal Health Center for your child’s Health/Dental Care. Please arrive 1 hour prior to your child’s scheduled appointment to allow us adequate time to establish their chart. When you arrive, you will need to fill out our registration forms.

WHAT TO BRING

We will need the following original documents only for scanning at the time of your first visit. 

  • Parent/Guardian’s Current State Photo ID/Driver’s License
  • Social Security Card
  • U.S. Federally Recognized Tribal Membership/Citizenship card OR Certificate Degree of Indian Blood (CDIB)
  • Vital Statistics or State Certified Birth Certificate
  • Insurance Cards (Private Insurance, Medicare or Medicaid)
  • Current Proof of Residency (For patients who reside within the Kickapoo Contract Health Service boundaries, Proof of Residence includes utility bill, pay stub, lease/rental agreement or mortgage statement in parent/guardian’s name w/current address and current month)
  • Legal Guardianship Documentation (If applicable)

Patient Registration

Our Patient Registration team is available to assist with:

  • New and returning patient registration
  • Demographic updates
  • Insurance verification
  • Patient check-in
  • Collection and verification of required registration documents

If you have any questions, please feel free to contact us at 405-964-2081 Ext. 221, 242 or 223.

Health Information Management (HIM)

The Health Information Management department provides:

  • Medical Record Requests (Release of Information)
  • Medical Record Maintenance
  • Document Scanning and Indexing
  • Record Integrity
  • Notary Services (available during normal business hours)

To request medical records, patients must complete a Release of Information (ROI) form. If you would like to download, print, and fill out the form prior to arriving, click here. Forms may be completed in person at the Health Information Management office. If you have questions regarding Release of Information, please call (405) 964-2081 ext 271

For Notary services, please call ahead to ensure a notary is available.

CONTACT US

Main: 405.964.2081 ext 221
Release of Information: 405.964.2081 ext 271
HIM Fax: 405.964.2722