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Forms

We're here for you. Member to member.

Filling out the forms:

  1. Use the Form page instructions, if needed, to help find the form you need.
  2. Open the form by clicking the Title.
  3. Download or Save the form to the Documents folder on your computer.
  4. Open the form from your computer, and be sure to fill in all Required Fields
  5. Save your PDF before sharing it!
  6. The last page of each form has information about where to Send it.

Not sure which form to fill out or have other benefit related questions?  
Contact Member Services at (503) 373-1102 or inquiries.pebb@dhsoha.state.or.us

We are experiencing a higher than normal call volume. Please leave a message for Member Services and they will return your call within 24-48 hours, or you may choose to email your question instead. 

We want to be supportive! For the best experience, please do not view this page in Internet Explorer.
 





Searching for a Form

Keep search terms simple!

  1. Enter one word, such as, 'new,' 'change,' 'divorce,' 'affidavit, enrollment, fsa, etc.

Forms-Page-Directions.JPG 

Other search options:

Sorting:
  1. Click desired column Header (example: category, url, descripton, form number) to sort OR;
  2. Use Sort dropdown and choose a different column to sort A-Z.
Filtering: 
  1. Click Filter dropdown to choose filter options or;
Viewing More Pages:
  1. Click Next at the bottom of the forms list, if needed OR; 
  2. Use the 'Per Page' dropdown located in the lower right hand corner to adjust how many forms you see on one page.

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