Member Forms

Member Services

Advance Directive

Appeal and Hearing Request Form

Solicitud de apelacion y audiencia por negacion de servicios medicos (Appeal and Hearing Request Form Spanish)

Advanced Health Member Complaint Form and Information Packet

Formulario de Quejas del Plan de Salud de Oregon (OHA Spanish Complaint Form)

Administrative

Flex Fund Request

Website Privacy Policy

La Póliza de Privacidad del Sitio Web (Website Privacy Policy-Spanish)

Website Privacy Policy Large Print

Oregon Health Plan

Release of Information

Autorización para el uso y divulgación de información personal (Release of Information Spanish)

Client Agreement to Pay for Health Services

Acuerdo del cliente para pagar los servicios de salud (Client Agreement to Pay for Health Services Spanish)

Notice of Privacy Practices

Advanced Health is committed to protecting your information.  Please see the following document in English and Spanish that explains how we protect your health information and explains your rights and our responsibilities.

Advanced Health Notice of Privacy Practices

Aviso de prácticas de privacidad (Advanced Health Notice of Privacy Practices – Spanish) Version