Umpqua Health Members

Documents & Forms

If you can’t find what you’re looking for below, our Customer Care team can help.

Movement is Medicine Walking Group Flyer 2026 -English

Flyer for the Cow Creek Health and Wellness Walking Group meeting every 2nd and 4th Tuesday from 9–10 AM at Millsite Park in Myrtle Creek, offering Umpqua Health members a guided walk with a Registered Dietitian to improve health, build community, and connect with nature. Contact Claire Grubb, RD: (541) 672-8533 ext. 5266.

NEMT Policy

Umpqua Health Alliance corporate policy (CO29, Version 7) establishing the Non-Emergent Medical Transportation (NEMT) Quality Assurance Program and Plan, outlining how Umpqua Health monitors and evaluates NEMT services to ensure compliance with all Federal, State, and contractual requirements for OHP members.

Release of Information

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

Housecall Providers Palliative Care handout

Handout introducing Housecall Providers, a nonprofit delivering in-home medical and advanced illness care, and describing how Umpqua Health members with serious illness can access palliative care and support services at home.

Advanced Illness Care Referral Form

Referral form for Advanced Illness Care services through Housecall Providers, used by health plans, hospitals, and clinics to refer Umpqua Health OHP members for in-home palliative care, submitted by fax with recent clinical notes, labs, and a provider order.

Transition of Care Policy

Umpqua Health Alliance corporate policy (CE28) governing Transition of Care for members enrolling in or disenrolling from the plan, ensuring continuity of physical health, behavioral health, dental, and LTSS services during care transitions in compliance with OAR 410-141-3850.

Advance Directives Policy

Umpqua Health Alliance corporate policy (Version 6) outlining procedures for advance directives, including how member healthcare wishes and end-of-life preferences are documented, communicated, and honored.

Professionally Administered Drug (PAD) Grid

This authorization grid pertains to professionally administered drugs given by healthcare providers in clinical settings, including offices, outpatient hospitals, or home infusion therapy services.

Postpartum Check-Up Flyer – Spanish

Folleto en español de Umpqua Health Alliance sobre el chequeo posparto, con información de contacto para el equipo de atención al cliente disponible de lunes a viernes.

Postpartum Check-Up Flyer – English

Flyer encouraging Umpqua Health members to schedule their postpartum check-up within 1–12 weeks of giving birth, explaining the importance of the visit for recovery and support, with Umpqua Health Customer Care contact information.

Member Benefits Summary Flyer – Spanish

Conozca los servicios para miembros disponibles sin costo.

Member Benefits Summary Flyer

Learn about the member services available at no cost.