Members Handbook – Machine Readable
Appeals and Hearings Flowchart
Learn more about the process we follow for appeals and hearings.
Community Advisory Council Application
Use this form to apply to be a member of our Community Advisory Council.
Health Risk Assessment (HRA) – Spanish
La HRA se utiliza para ayudarnos a comprender sus necesidades como miembro de Umpqua Health.
Health Risk Assessment (HRA)
The HRA is used to help us understand your needs as an Umpqua Health member.
GMR Appointment Verification Form – Spanish
Utilice este formulario para solicitar el reembolso del kilometraje de combustible para el transporte médico no urgente (NEMT).
NEMT & BCB Brochure – Spanish
Obtenga más información sobre cómo obtener viajes gratuitos a sus citas.
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.