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This Form is used for applying for temporary medical assistance in Oregon for individuals without insurance.
This form is used for reporting the mental residual function capacity of an individual in Oregon. It includes details about their ability to perform tasks related to mental functions. This information is important for determining eligibility for certain benefits and services.
This Form is used for authorizing the release of medical records for an administrative medical examination in Oregon.
This form is used for obtaining informed consent from a patient undergoing a hysterectomy procedure in the state of Oregon.
This form is used for obtaining consent for a hysterectomy procedure in the state of Oregon.
This Form is used for obtaining consent for sterilization for individuals aged 21 and up in the state of Oregon.
This form is used for reporting on eye examinations in the state of Oregon. It is necessary for documenting the results and findings of an eye examination.
This form is used for requesting non-emergent medical transportation for completing an administrative medical examination in Oregon.
This form is used for reporting the physical residual function capacity in Oregon.
This document is used to authorize sterilization for individuals aged 15-20 in Oregon.
This Form is used for rating and reporting the severity of impairments in Oregon.
This Form is used for conducting a lead risk assessment in the state of Oregon. It helps identify potential lead exposure hazards in a residential or commercial property.
This Form is used for keeping track of medical records in Oregon. It helps ensure that all necessary documents are in place for a patient's medical history.
This Form is used for obtaining consent for sterilization in Oregon for individuals between the ages of 15-20.
This document is used for reporting industrial stormwater permits Tier 1 in Oregon. It provides information on industrial facilities and their compliance with stormwater regulations.
This document is used for certifying mass reduction measures in the Industrial Stormwater General Permit in Oregon.
This document is an application for a Dental Hygiene Expanded Practice Permit - Pathway 2 in the state of Oregon. It allows dental hygienists to perform specific expanded duties under certain conditions.
This document is used for reporting the inventory of wild turkeys in Oregon. It is a form that allows individuals to provide information on the population of turkeys in the state.
This form is used for attaching provider enrollment information for behavior rehabilitation services in the state of Oregon.
This Form is used for enrolling health centers in Oregon and is an attachment to the OHP3104 Provider Enrollment Form.
This Form is used for providers in Oregon to disclose their ownership and control information, business transactions, and criminal convictions. It helps ensure transparency and compliance in the healthcare industry.
This Form is used for hospitals in Oregon to attach additional information when enrolling as a provider under the Oregon Health Plan.
This form is used for provider enrollment attachment for durable medical equipment (DME) in Oregon.
This form is used for providers who are applying for enrollment as an independent radiology provider in the state of Oregon.
This Form is used for attaching school medical information to the Provider Enrollment in Oregon.
This form is used for provider enrollment attachment for targeted case management in the state of Oregon.
This document is used for renewing benefits for the Oregon Health Plan in Oregon.
This document is for out-of-state licensees who need to report their taxes to the Oregon Wine Board. It provides a statement for tax reporting purposes.
This document is used for in-state licensees of the Oregon Wine Board to report and submit tax statements related to wine sales in Oregon.
This document is for individuals attending a law orientation in Oregon. It may require an affirmation, or a sworn statement, regarding the attendee's understanding and commitment to the principles of the legal profession.
This document outlines the policy for the deferral of renewal fees for Oregon Liquor Control Commission (OLCC) licenses during the COVID-19 pandemic. Licensees must acknowledge their understanding of the policy.