Patient Information and Forms

Thank you for choosing Yellowhawk Tribal Health Center!

We have prepared this Managed Care Handbook to help you understand how managed care services are offered through Yellowhawk Tribal Health Center (YTHC). We hope it will answer many of your questions about your benefits, eligibility, and the various requirements associated with access to the Managed Care Program.

YTHC is mandated by Federal Regulation 42CFR regarding eligibility for services.
The Federal regulations determine eligibility. 

The Patient Benefit Coordinator can also be contacted at 541.278.7540
with any additional questions or concerns. 



 
 
 
Completing these forms in advance can save you time at your next appointment:




PAO21 Form must be kept on file and current

Other Necessary Documentation:
Proof of Native descent or Certificate of Indian blood (CIB)
Copy of Birth Certificate
Social Security Card
Proof of Residency



All PDF downloads (handbook and forms) are also available for pick-up at YTHC



Toll-free Number: 888.YEL.HAWK (888.935.4295)
PO Box 160 / 73265 Confederated Way / Pendleton, OR 97801
Phone 541.966.9830 / Fax 541.278.7579 / Medical Records Fax 541.278.7570

  2013 Yellowhawk Tribal Health Center
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