NOABD FAQs
Find answers to frequently asked questions about adverse benefit determinations.
Appeals & Hearing Request (Spanish)
Utilice este formulario para enviar una solicitud de audiencia a la Autoridad de Salud de Oregón (OHA).
Appeals & Hearing Request
Use this form to submit a hearing request to the Oregon Health Authority (OHA).
UHA Complaint Form (Spanish)
Utilice este formulario para enviar una queja por escrito a Umpqua Health.
UHA Complaint Form
Use this form to submit a written complaint to Umpqua Health.
Grant Application Budget Form
Form W-9
HRSN Nutrition Service Request Form
Use this form to request nutrition assistance services.
HRSN Housing Service Request Form
Use this form to request housing assistance services.
HRSN Climate Service Request Form
Use this form to request a climate device (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.