Umpqua Health Providers

Documents & Forms

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

Notice of Privacy Practices

NOTICE OF PRIVACY PRACTICES. This notice explains how your medical information may be used and shared and how you can access your information. Please review it carefully.

Community Advisory Council Application

Use this form to apply to be a member of our Community Advisory Council.

Patient Privacy and Security Resources – Supporting Payers Educating their Patients

UHA Comprehensive Formulary

Umpqua Health Alliance Formulary (Preferred Drug List) provides information on covered medications, coverage rules, and formulary status to help members and providers make informed pharmacy decisions.

Informed Consent Form – Consent to Sterilization for Members 15 – 20

Informed Consent Form – Consent to Sterilization for Members 15 – 20 (Spanish)

Informed Consent Form – Consent to Sterilization for Members 21+ (Spanish)

Informed Consent Form – Consent to Sterilization for Members 21+

Informed Consent Form – Hysterectomy Consent (Spanish)

Informed Consent Form – Hysterectomy Consent