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Documentos y formularios

Si no encuentra lo que busca, nuestro equipo de atención al cliente puede ayudarle.

HRSN MTM Assessment Referral Form

This form can be used by PCPs and Registered Dieticians to complete the required assessment for members seeking HRSN Medically Tailored Meals (MTM).

HRSN MTM Benefit Overview

This guide provides an overview of the HRSN Medically Tailored Meals benefit for clinics and providers who may have patients with eligible conditions.

Potential Quality of Care Concern Referral & Investigation Form

Use this form to report potential quality-of-care concerns for UHA members. UHA reviews and investigates referrals to support safe, high-quality care across our contracted provider network.

Quality Pool Distribution Plan

UHA’s distribution plan for its Quality Pool and Challenge Pool earnings. The purpose of the plan is to inform UHA’s Participating Providers, including Social Determinants of Health and Equity (SDOH-E) and public health partners, about UHA strategies and processes for distribution of Quality Pool funds.

Member Handbook – Spanish

2025 Member Handbook in Spanish

Release of Information

This is a form for members to authorize the release of information.

Housecall Providers Palliative Care handout

Advanced Illness Care Referral Form

Health Literacy and Vaccine Hesitancy: Clearer Communication for Better Outcomes

Health Literacy and Vaccine Hesitancy: In Clearer Communication for Better Outcomes, Dr. Cliff Coleman offers individual and community-level approaches to thinking about vaccinations and explores how health literacy and clear communication can facilitate or impede our ability to achieve vaccination goals. For CME certificate, provide your information here:  Please disregard the QR code at the end of the video. If you encounter any issues, please contact UHQualityImprovement@umpquahealth.com for assistance.