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Client Enrollment

Enrollment Form 

Learn about RH Program Enrollment Form and how staff can help clients enroll in the RH Program.

RH Program ClinicsVideo Slides (with clickable links)

CCare-only ClinicsVideo | Slides (with clickable links)

Immigration, Data Privacy, and Public Charge 

Learn how information collected on the RH Program Enrollment Form is used and/or shared with others; key talking points for clinic staff working with immigrant clients; and answers to questions related to data privacy and public charge.

Immigration, Data Privacy, and Public Charge

Eligibility Database 101

Learn how to use the RH Program Eligibility Database to finish enrolling clients in the RH Program.

RH Program ClinicsVideo | Slides (with clickable links)

CCare-only ClinicsSlides (with clickable links)

Eligibility Database: How to search for a client (3 mins)

It is really important to search for a client in the Eligibility Database BEFORE asking them to complete a new enrollment form. This short video (3 mins) shows you how to do that: 

  How to Search for a Client in the Eligibility Database


Eligibility Database

Clients' information must be entered into the RH Program Eligibility Database for their enrollment to be complete.

To gain access to the Eligibility Database, complete and submit one of the two forms below:

    Ahlers User ID/Password for agencies with 1-9 clinics
  
    Ahlers User ID/Password for agencies with 10 or more clinics

For instructions of how to use the Eligibility Database see our Eligibility Database Instructions (includes screenshots).


Client Eligibility Verification

The RH Program verifies all clients' income and the citizenship / immigration status of clients who claim U.S. citizenship/national status or eligible immigration status. The resources below help clinic staff understand the verification processes and what they can do to help clients.

Verification FAQs: explain the eligibility verification process and answers frequently asked questions.

Eligibility Status Update Guide: describes the monthly status update email. Includes samples, describes what is included, and what action clinic staff should take.

Income Process Flowchart: illustrates the state's income verification process and what clinic staff should do.


CCare Corner

Resources for clinics that only operate CCare (not the full RH Program).

Enrollment Form Cover Page

This cover page informs clients of what services they can get at a CCare-only clinic, and where they can get additional services offered through the RH Program. Clinics can add their local RH Program clinic locations at the bottom of the page.

English
Spanish
Simplified Chinese
Korean
Russian 
Vietnamese


CCare Eligibility Tip Sheet

A quick-look resource for common eligibility questions around insurance coverage, income, and citizenship requirements. Click the link below and post it at the front desk for easy reference!

CCare Eligibility Tip Sheet


Notice of Privacy Practices

Clients must also be offered the OHA Notice of Privacy Practices (NOPP). To access the English version click the first link below. The second link allows you to access the NOPPs in different languages.

OHA Notice of Privacy Practices (English)

To order in different languagesconfidential-stamp.jpg


Voter Registration

Clients must be offered the chance to register to vote. See the policy, procedures, and associated forms below:

National Voter Registration Act (NVRA) Policies and Procedures

2018 NVRA Agency Manual

SEL 503 - Voter Registration Card

SEL 503a - Spanish Voter Registration Card

SEL 504 - Agency Voter Registration Reporting Form (new online form)

SEL 540 - Signature Stamp Attestation Form


Out-of-State Birth Certificate Requests

The Oregon Reproductive Health Program will order birth certificates from other states to help non-Oregon born RH Program applicants document U.S. citizenship. The materials and links below explain this process.

Instructions for Requesting Out-of-State Birth Certificates

Information about Becoming a Notary (link to Secretary of State website)

OHA Authorization form: Authorizes client's release of certificate to State of Oregon (Required)


Client Enrollment Tools

All documents are in PDF format.

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