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URBAN INDIAN CENTER OF SALT LAKE

Formerly known as the

Indian Walk-In Center

Along with documentation, an intake form must be completed; the form can be found below or filled out at time of registration.

Intake Form

Please note: This form is required for all new clients and those who have not been to the center for a period of greater than 5 years.

In order to be eligible for our programs and services applicants must bring the following:

  • Certificate of Indian Blood (CIB) or Tribal I.D. (Identification card) A CIB must include the degree of Indian Blood (ex: 1/2, 1/4, etc.)
  • Social Security Card (or letter from Social Security Administration indicating you have ordered a new or duplicate card)
  • Current Driver’s License or Photo ID (if registering your child, please bring parent[s] photo ID)
  • Proof of residency (rental/lease agreement, mortgage, or official mail)
  • Verification of Income (if applicable) Two pay stubs including SSI or Unemployment
  • Proof of Medical Insurance  Insurance card (if applicable)

All documentation is required at the time of registration.

health program