PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form IHS-963
for the current year.
Form IHS-963 Request for Confidential Communication by Alternative Means or Alternate Location
What Is Form IHS-963?
This is a legal form that was released by the U.S. Department of Health and Human Services - Indian Health Service on April 1, 2009 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form IHS-963?
A: Form IHS-963 is a request for confidential communication by alternative means or alternate location.
Q: What is the purpose of Form IHS-963?
A: The purpose of Form IHS-963 is to request that confidential communications from the Indian Health Service (IHS) be made through alternative means or at an alternate location.
Q: Who can use Form IHS-963?
A: Anyone who receives services from the Indian Health Service (IHS) and wishes to have their communications kept confidential can use Form IHS-963.
Q: What information is required on Form IHS-963?
A: Form IHS-963 requires information such as the individual's name, contact information, preferred method of communication, and any specific requests regarding alternate location.
Q: How should I submit Form IHS-963?
A: Form IHS-963 should be submitted to the Indian Health Service (IHS) facility where you receive services, either in person or by mail.
Q: Is there a deadline for submitting Form IHS-963?
A: There is no specific deadline for submitting Form IHS-963, but it is recommended to submit it as soon as possible to ensure timely and confidential communication.
Q: Can I revoke or change my request made on Form IHS-963?
A: Yes, you can revoke or change your request made on Form IHS-963 by submitting a new form or notifying the Indian Health Service (IHS) facility in writing.
Q: Are there any fees associated with Form IHS-963?
A: No, there are no fees associated with submitting Form IHS-963.
Q: What should I do if I have questions about Form IHS-963?
A: If you have questions about Form IHS-963, you can contact your local Indian Health Service (IHS) facility for assistance.
Form Details:
- Released on April 1, 2009;
- 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-963 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.
