This is a legal form that was released by the Oregon Health Authority - a government authority operating within Oregon. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is OHP3166?
A: OHP3166 is the Ohp Client Agreement to Pay for Pharmacy Services form in Oregon.
Q: What does the OHP3166 form do?
A: The OHP3166 form is used to authorize the client to pay for pharmacy services that are not covered by the Oregon Health Plan (OHP).
Q: Who needs to fill out the OHP3166 form?
A: Clients who are enrolled in OHP and wish to pay for pharmacy services that are not covered by OHP need to fill out the OHP3166 form.
Q: Are there any fees associated with the OHP3166 form?
A: No, there are no fees associated with the OHP3166 form.
Form Details:
Download a fillable version of Form OHP3166 by clicking the link below or browse more documents and templates provided by the Oregon Health Authority.