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.
HRSN Housing Supplemental Income Worksheet
Use this form if you need to share income information for other adults in your home as part of your HRSN request.
UHA Community Health Improvement Plan
The CHP is a five-year plan to systematically address community health issues based on the Community Health Assessment (CHA).
UHA Community Health Assessment 2023
This report highlights five-year health trends in Douglas County and illustrates various health and social data indicators.
Members Handbook
What’s in Your Handbook?Your Member Handbook explains your covered services, how to get care when you need it, and what to do in an emergency. It also includes tips for staying healthy, choosing a provider, and finding important phone numbers and resources.