Form IHS-976 Purchased/Referred Care Proof of Residency

Form IHS-976 Purchased/Referred Care Proof of Residency

What Is Form IHS-976?

This is a legal form that was released by the U.S. Department of Health and Human Services - Indian Health Service on October 1, 2017 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2017;
  • The latest available edition released by the U.S. Department of Health and Human Services - Indian Health Service;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form IHS-976 by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services - Indian Health Service.

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