HRSN Home Changes For Health Request Form
Use this form to request a HRSN Home Changes For Health (such as an air conditioner or portable heater).
UHA Information Sharing Authorization Form
This form gives us permission to send details about your HRSN service request to one of our partners.
Verification of Landlord/Tenant Relationship and Rent Owed
HRSN Housing Supplemental Income Worksheet
Use this form if you need to share income information for other adults in your home as part of your HRSN request.
Members Handbook
Your Member Handbook has everything you need to know about being an Umpqua Health member.