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.
NOABD FAQs (Spanish)
Encuentre respuestas a preguntas frecuentes sobre determinaciones adversas de beneficios.
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.
HRSN Nutrition Service Request Form
Fully fillable Nutrition Request Form for members and providers requesting Health-Related Social Needs (HRSN) nutrition services and related benefits.
HRSN Housing Service Request Form
Use this form to request housing assistance services.
HRSN Home Changes For Health Request Form
Use this form to request a HRSN Home Changes For Health (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.
Verification of Landlord/Tenant Relationship and Rent Owed
Verification form for Umpqua Health Alliance’s Health-Related Social Needs Rental Assistance Program, documenting landlord/tenant relationship and confirming rent owed when no written lease exists.