Oregon Health Plan (OHP) Referral Form

We’re here to serve our Latinx community! Are you a Multnomah or Clackamas County resident that has questions or needs assistance on enrolling your child, teen or family to Oregon Health Plan (OHP) or Citizen Alien Waived Emergent Medical (CAWEM)?

The OHP Referral Form is OLHC’s bilingual referral form was created to connect community members to Community Health Workers (CHWs) for OHP or CAWEM assistance. Please complete this OHP referral form, and one of OLHC’s bilingual (Spanish/English) CHWs/Promotoras will get back to you.

Click here to complete OHP referral form or copy/past the following link into your URL: https://forms.gle/vToMmeNVFwSLD8j68 

Please note: to submit a referral to an OHP-certified organization outside of Multnomah or Clackamas counties, please refer to the Public Search Tool: https://healthcare.oregon.gov/Pages/find-help.aspx