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12743 SU Where Entered Employee ID Severity Hospitalized Fatal DOB Gender Male Female / / Infant Age In Months Age In Years SU of Occurrence Community of Occurrence North GPS Coordinates Transported
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Who needs the Navajo Area IDSS Form PDF?
01
Individuals and families who reside in or are affiliated with the Navajo Area jurisdiction.
02
Those who require Navajo Area Indian Health Service (IHS) services, such as healthcare, community health programs, or health-related assistance.
03
Applicants for specific health programs or benefits administered by the Navajo Area IDSS, such as the Special Diabetes Program for Indians or the Navajo Birth Certificate Delayed Registration Program.
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