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Client Enrollment

Policy Change - Sterilization No Longer Disqualifies a Person from Enrolling in the RH Access Fund!! 
We are working on revising and translating the enrollment form, and updating our trainings to reflect this change. In the meantime, our enrollment tools have been updated, and the RHAF Eligibility Database now allows clients who have been sterilized to enroll. For more information, please see the September, 8th 2023 Newsletter.
This page has resources and tools to help clinic staff with the client enrollment process. Click the jump links below to get to specific sections of the page:

RH Access Fund Enrollment Form

To enroll in the RH Access Fund, clients must complete the RH Access Fund Enrollment Form. Use the links below to print the form in any of the available languages, or to have the client complete the form electronically.
English Spanish
Korean Marshallese
Russian Simplified Chinese
Vietnamese Somali
For instructions on how the Enrollment Form should be completed see our Enrollment Form Guide.
For guidance on how to enroll a client who is not in the clinic see our Remote Enrollment Guidance.
To order more printed Enrollment Forms for your clinic, please complete this Order Form.


Client Enrollment Process (updated December 2023)

Learn more about the enrollment form and process as well as how to use the eligibility database. This training is for RHCare, CCare, and AbortionCare Clinics. Following the training, take the short Test Your Knowledge quiz. This can be accessed via the QR code at the end of the training or by following the link listed on the slide. 

Video | Slides (with clickable links)

Eligibility Database

All client enrollment data, from the Enrollment Form, must be entered and saved in the Eligibility Database for the client to be considered fully enrolled.

Eligibility Database Instructions (includes screenshots)
To gain access to the Eligibility Database, complete and submit one of the two forms below:

Eligibility Verification

The RH Program verifies the income and the citizenship status of enrollees who mark U.S. Citizen on the Enrollment Form. The resources below help clinic staff understand the verification processes and what they can do to help enrollees.

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

CCare Corner

Enrollment Form Cover Page

This cover page tells clients what services they can get at a CCare clinic, and where they can get additional services offered at RHCare clinics. 

Simplified Chinese
Korean Russian 

CCare clinics can add local RHCare clinic locations at the bottom of the page.

Tip Sheet

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

Eligibility & Billing Tip Sheet

Notice of Privacy Practices

Enrollees must be offered the OHA Notice of Privacy Practices (NOPP). 

OHA Notice of Privacy Practices (English)

To order in different languages

Voter Registration

Enrollees 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

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 Access Fund enrollees 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

Have enrollment questions? Email