Oregon authorization 2026

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The document is an authorization form that allows a health care provider to use and disclose an individual's protected health information (PHI) in accordance with ORS 192.559. It outlines the necessary provisions for disclosing specific health information, including types of sensitive information such as HIV/AIDS, mental health, genetic testing, and drug/alcohol treatment. The form emphasizes that signing is not mandatory for receiving healthcare services and provides details on revocation of the authorization.

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Click ‘Get Form’ to open the Oregon Authorization form in our editor.
In the first section, enter the name of the person or entity that will disclose your health information. This is crucial for identifying who is authorized to share your data.
Next, provide the name of the individual whose health information is being disclosed. Be sure to include any specific details about the health information you wish to share in the designated area.
Fill in the recipient's name and address where this information will be sent. This ensures that your data reaches the correct party.
Clearly state the purpose of disclosure. You can describe each reason or indicate if it’s at your request, which helps clarify why this information is being shared.
If applicable, initial next to any types of sensitive information (like HIV/AIDS or mental health records) that you authorize for disclosure. This step is essential for compliance with additional laws.
Finally, sign and date the form at the bottom. If you're a personal representative, include a description of your authority as well.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Is Oregon tax ID the same as EIN?

Note: An EIN Number is not the same thing as an Oregon State Tax ID Number. An EIN is issued by the IRS. And an Oregon Tax ID Number is issued by the Oregon Department of Revenue.

What is the Oregon Health Authority?

The Oregon Health Authority (OHA) oversees a system of coordinated care organizations (CCOs) that serve most of the more than 1 million members of the Oregon Health Plan, Oregons Medicaid program.

What is Oregon doing to protect immigrants?

2021: Oregon passes the Sanctuary Promise Act. This law limits cooperation between local law enforcement and federal immigration authorities. January 2025: President Donald Trump takes office for the second time.

What is the income limit for Oregon Health Authority?

Oregon Health Plan (OHP / Medicaid) is funded by both Oregon and the federal government. The program provides health coverage to 1.4 million people in Oregon.

What is the purpose of the Oregon Health Authority?

The Oregon Health Plan (OHP) is our states Medicaid program. It provides no-cost health coverageincluding medical, dental and mental health and substance use benefitsto individuals and families who qualify.

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