UHA Riders Guide – Spanish
Obtenga más información sobre cómo obtener viajes gratuitos a sus citas.
UHA Riders Guide
Learn more about getting free rides to your appointments.
NEMT & BCB Brochure
Learn more about getting free rides to your appointments.
GMR Appointment Verification Form
Use this form to request gas mileage reimbursement for non-emergency medical transport (NEMT).
Postal Prescription – New Customer Order Form
Use this form to sign up for medication by mail.
Postal Prescription – Quick Reference Guide
Review this guide to find tips and answers to questions for medication by mail.
Machine-Readable Formulary
Machine-readable formulary data file (effective April 2026) for Umpqua Health Alliance’s Oregon Medicaid plan, listing covered medications with NDC codes, drug tier assignments, prior authorization requirements, step therapy, and quantity limits in a structured JSON format for interoperability.
UHA Comprehensive Formulary
UHA Formulary (Preferred Drug List) provides information about covered medications, including drugs available to Umpqua Health Alliance members and applicable pharmacy coverage requirements.
Informed Consent Form – Consent to Sterilization for Members 15 – 20
Oregon Health Plan informed consent form for sterilization procedures for members ages 15–20, meeting federal Medicaid requirements and informing patients of their right to withdraw consent at any time.
Informed Consent Form – Consent to Sterilization for Members 15 – 20 (Spanish)
Formulario de consentimiento informado en español para procedimientos de esterilización para miembros del Plan de Salud de Oregon de 15 a 20 años, conforme a los requisitos federales de Medicaid.
Informed Consent Form – Consent to Sterilization for Members 21+ (Spanish)
Formulario de autorización de esterilización en español para miembros del Plan de Salud de Oregon de 21 años o más, conforme a los requisitos federales de Medicaid sobre consentimiento informado.
Informed Consent Form – Consent to Sterilization for Members 21+
Oregon Health Plan informed consent form for sterilization procedures for members ages 21 and older, meeting federal Medicaid requirements and disclosing the permanent nature of the procedure.