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Forms: Oregon Health Plan (OHP)
and DHS Division of Medical Assistance Programs (DMAP)

OHP forms (PDF)

OHP 3001
OHP Complaint Form; also in Spanish

 

OHP 3259

Oregon Health Plan - Can I be on the OHP and have private health insurance; also in Spanish


OHP 3261
Inpatient Hospital Hold Request

 

OHP 3360
Pregnancy Notification

 

OHP 7206  

U.S. Citizenship and Identity Requirements; also in Spanish

 

OHP 7207

Continuity of Care Referral

 

OHP 7208M
Medicare Advantage Plan Election; also in Spanish

 

OHP 7209
Request to Terminate Insurance (Rev. 5/05)

OHP 7210
OHP Application (Sample Only)

 

OHP 7210 PKT
OHP Application Packet

 

OHP 9035
Oregon Health Plan - Client Handbook; also in Spanish

 

DMAP forms

300 Series
400 Series
500 Series
700 Series
1000 Series


  1200 Series
2400 Series
3000 Series
3100 Series
3200 Series
3300 Series
6000 Series
9000 Series

Miscellaneous Forms

Formularios de DMAP y OHP en español

DMAP and OHP forms in Spanish and other languages

Other DHS forms

 
Page updated: February 29, 2008

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