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Southwestern Indian Polytechnic Institute

Indian Health Services & Purchase Referred Health Care

 

Once you are a student at SIPI, fill out the Purchase Referred Health Care form and obtain the Registrar's signature and date.  Forms can be picked up from the Student Affairs Office, Building 101, Room 143.  Once form is filled, keep a copy and send form to your Indian Health Service or Purchase Referred Health Care facility.

 

The form will notify your local Indian Health Care facility that you are attending SIPI and in case of medical emergencies you will have a form on file.  If you take time off from SIPI, notify your local Indian health facility that you will be returning to SIPI campus.

 

 

 
Emergency Care Banner
 

After you visit an emergency department or urgent care clinic, you must notify your Indian Health Services (IHS) Purchase Referred Care office within 72 hours (three calendar days). IHS Purchase Referred Care determines eligibility for coverage based on:

 
  • Where you live
  • Tribal affiliation
  • Health coverage (Medicaid, Medicare or private health insurance)
  • Whether you notified IHS within three days of care