I Speak Languages Card
OHA language identification card for use in health care settings, helping patients indicate their preferred language to support language access rights for Oregon Health Plan members.
HRS Flex Assistance Request Form
Use this form to submit a request for assistance through the HRS Flex services program.
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
CMS resource guide supporting health plan payers in educating members about patient privacy, data security, and rights under the Interoperability and Patient Access Final Rule.
Machine-Readable Formulary
Machine-readable formulary data file (effective April 2026) for Umpqua Health Alliance’s Oregon Medicaid plan, listing covered medications with NDC codes, drug tier assignments, prior authorization requirements, step therapy, and quantity limits in a structured JSON format for interoperability.
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.
Informed Consent Form – Consent to Sterilization for Members 15 – 20
Oregon Health Plan informed consent form for sterilization procedures for members ages 15–20, meeting federal Medicaid requirements and informing patients of their right to withdraw consent at any time.
Informed Consent Form – Consent to Sterilization for Members 15 – 20 (Spanish)
Formulario de consentimiento informado en español para procedimientos de esterilización para miembros del Plan de Salud de Oregon de 15 a 20 años, conforme a los requisitos federales de Medicaid.
Informed Consent Form – Consent to Sterilization for Members 21+ (Spanish)
Formulario de autorización de esterilización en español para miembros del Plan de Salud de Oregon de 21 años o más, conforme a los requisitos federales de Medicaid sobre consentimiento informado.
Informed Consent Form – Consent to Sterilization for Members 21+
Oregon Health Plan informed consent form for sterilization procedures for members ages 21 and older, meeting federal Medicaid requirements and disclosing the permanent nature of the procedure.
Informed Consent Form – Hysterectomy Consent (Spanish)
Formulario de consentimiento para histerectomía en español del Plan de Salud de Oregon, con secciones para pacientes que pueden otorgar consentimiento y para situaciones de emergencia, conforme a los requisitos de Medicaid.
Informed Consent Form – Hysterectomy Consent
Oregon Health Plan informed consent form for hysterectomy procedures, including sections for patients capable of providing consent and for emergency situations, meeting Medicaid requirements.