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New Patient Information, Forms & Policies

New Patient

Our Siletz Community Health Clinic services CTSI tribal, other Federally Recognized tribal, and community members.   CTSI and Federally Recognized tribal members may receive most SCHC services at no cost after insurance.  Non-Federally Recognized tribal and Non-tribal members are responsible for the cost of services not covered by insurance.

If you are interested in becoming a patient you must complete the Registration Packet (found below) with the following required documents:

  • New Patient Registration
  • Birth certificates (under age 18)
  • Insurance card(s)
  • Photo ID (age 18 and older)
  • Social Security card or Number
  • Tribal ID (if applicable)

You may submit your registration with required documents:

  • In person to our Patient Care Coordinators located at our Reception area
  • By Fax: 541-444-9695
  • By Mail: PO Box 320; Siletz, OR 97380
  • By Email: medicalrecords@ctsi.nsn.usnote email is insecure at your discretion 

Medical appointments may be made by calling 800-648-0449 or 541-444-1030, Opt. 1. You need to check in at SCHC Reception area 15 minutes prior to appointment.