Oregon dhs listing 2025

1. Click ‘Get Form’ to open the Oregon DHS Listing form in the editor.
2. Begin by filling in your name as it appears on IRS records in the designated field. Ensure you use black or blue ink and print clearly.
3. Provide your Social Security number or IRS number, followed by your email address. This information is crucial for processing your application.
4. Complete the sections regarding your address, phone number, and preferred language. If applicable, indicate if you provide care in the home where the child lives.
5. Answer all questions related to Basic Provider Requirements and Health and Safety Requirements thoroughly. Mark 'Yes' or 'No' as appropriate.
6. If required, confirm completion of the Health and Safety Training before submitting the form. Attach any necessary certificates if applicable.
7. Review all entries for accuracy before saving your changes. Once complete, print the form and mail it to the Direct Pay Unit at P.O. Box 14850, Salem, OR 97309-0850 or fax it to 503-378-5953.

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