Member Resources and Forms
CHA works with the Oregon Health Authority to give you the best healthcare possible. If you need help coordinating your medical, behavioral and/or dental benefits, please call our case management department at 541.883.2947.
Our Traditional Health Worker (THW) Liaison, Heather Robinson, Behavioral Health Manager, can be reached at 541.883.2947.
If you are looking for free or reduced services, enter your zip code below to be directed to our social service resource hub.
Additional Forms and Resources:
- Appeal a Service Denial and Hearing Request
- Approved Drug List (Formulary)
- CHA's Complaint Form
- Clinical Practice Guidelines
- Declaration of Mental Health
- Information on HPV Vaccination
- Information on Strengthening Your Baby's Immune System
- Intensive Care Management
- Living Well - Summer 2020 Issue
- Medication Prior Authorization Request Form
- Notice of Hearing Rights
- OHP Administrative Hearing Request
- OHP Client Agreement to Pay
- Other OHP Forms
- Preschool Promise
- Prioritized List
- Produce Connection Sites
- Provider Directory (English and Español)
- Sample CHA ID Card
- State of Oregon Advance Directive Form
- For more information about Advanced Directives, visit Oregon Health Decisions
Upon request, these material will be made available in other languages, large print, audio format, or a format that you prefer free of charge and within five business days.