Health Authority - IBM Knowledge Center

Official Website: https://aix-xweb1p.state.or.us

Forms & Documents

Browse all Health Authority - IBM Knowledge Center forms

1 - 20 of 156 forms

Form Title Topics
Administrative Medical Examination and Report Authorization
Advance Directive (English
Ages 15-20 Consent to Sterilization
Ages 15-20 Consent to Sterilization - Spanish
AI/AN Enrollment Status Change Request - For American Indian/Alaska Native clients can use this form to change their current fee-for-service ("open card") or OHP health plan enrollment
Appeal and Hearing Request
Appeal and Hearing Request (Russian
Appeal and Hearing Request (Somali
Appeal and Hearing Request (Spanish
Appeal and Hearing Request (Traditional Chinese
Appeal and Hearing Request (Vietnamese
Appeal and Hearing Rqeuest (Simplified Chinese
Application for Hospital Presumptive Eligibility - English (PDF
Application for Hospital Presumptive Eligibility - Russian (PDF
Application for Hospital Presumptive Eligibility - Somali (PDF
Application for Hospital Presumptive Eligibility - Spanish (PDF
Application for Hospital Presumptive Eligibility - Traditional Chinese (PDF
Application for Hospital Presumptive Eligibility - Vietnamese (PDF
Applicatoin for Hospital Presumptive Eligibility - Simplified Chinese (PDF
Approval Notice for Hospital Presumptive Eligibility Applicants - Somali

Contact Information & Office Locations

1 contact point

Address:
Corporate headquarters
1 New Orchard Road
Armonk, NY 10504-1722

Phone numbers:
  • (914) 499-1900
  • (800) 426-3383 (TTY Services (US))

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