Member Handbooks and Forms
All new members will receive a welcome packet that includes a copy of the Member Handbook. You can get a print copy of the Member Handbook at no cost to you.
Call Member Services at 1-877-600-5472; TTY: 711. We will mail a handbook to you within 5 business days. If you request that we email you the handbook, we will note it in your file. You must approve us to send it to you over email.
2021
- Member Handbook: Lane - Western Douglas - Western Linn Counties (PDF)
- Member Handbook: Lane - Western Douglas - Western Linn Counties Spanish (PDF)
- Member Handbook: Clackamas - Multnomah - Washington Counties (PDF)
- Member Handbook: Clackamas - Multnomah - Washington Counties Spanish (PDF)
- Member Handbook: Clackamas - Multnomah - Washington Counties Mandarin (PDF)
- Member Handbook: Clackamas - Multnomah - Washington Counties French (PDF)
2020
- Member Handbook: Lane - Western Douglas - Western Linn Counties (PDF)
- Member Handbook: Lane - Western Douglas - Western Linn Counties Spanish (PDF)
- Member Handbook: Clackamas - Multnomah - Washington Counties (PDF)
- Member Handbook: Clackamas - Multnomah - Washington Counties Spanish (PDF)
- Member Handbook: Clackamas - Multnomah - Washington Counties Mandarin (PDF)
2021
- Member Benefit Guide: Lane - Western Douglas - Western Linn Counties (PDF)
- Member Benefit Guide: Lane - Western Douglas - Western Linn Counties Spanish (PDF)
- Member Benefit Guide: Clackamas - Multnomah - Washington Counties (PDF)
- Member Benefit Guide: Clackamas - Multnomah - Washington Counties Spanish (PDF)
- Appeal Request Form (PDF)
- Advance Directive Form and Instructions (PDF)
- Member Prescription Drug Reimbursement Request (DMR)(PDF)
- Request to Change Lock-In Pharmacy and/or Provider (PDF)
- Authorization to Disclose Protected Health Information-English (PDF)
- Authorization to Disclose Protected Health Information-Spanish (PDF)
- Authorization to Disclose Protected Health Information-Russian (PDF)
- Authorization to Disclose Protected Health Information-Vietnamese (PDF)
- Authorization to Disclose Protected Health Information-Mandarin (PDF)
- Revocation of Authorization to Disclose Protected Health Information-English (PDF)
- Revocation of Authorization to Disclose Protected Health Information-Spanish (PDF)
- Request to Access (See) Records-English (PDF)
- Request to Access (See) Records-Spanish (PDF)