Patient Registration and Admissions
Welcome to the Leo Pocha Memorial Clinic. For questions about registration and services at the Helena Indian Alliance,
please call 406-442-9244.
Access to services at the Leo Pocha Memorial Clinic is not limited to Native American clients. For non-native clients, contact our business office to explore third party arrangements such as the ACA or Medicaid.
New Patient Registration (Form link down below)
- Completely fill out and sign a new patient registration, health history, HIPAA, and authorized release of health information if necessary.
- If applicable, make a copy of the following:
- Photo ID
- Tribal ID
- Social Security Card
- Birth Certificate
- Health Insurance Card
- Medicaid and Medicare Card
- If you do not have health insurance and are Non-Native
- Please fill out the sliding fee scale worksheet and a co-payment will be determined and required at the time of visit.
- Also, schedule a free appointment with Julie to help apply for health benefits.
- Turn in all registration materials to the Clinic Receptionist.
- The Clinic Receptionist will call you when your paperwork has been processed and entered into the Medical Information System (2-5 business days)
Thank you for your cooperation and we look forward to serving you!