You may fill out an application online or request a paper application.
- Online application. There is a 3-hour time limit for completing the online application. Once you have completed the application, you will need to fax or mail proof of income and other supporting documents. Note: proof and supporting documentation cannot be attached electronically.
- Paper application. To request an application be mailed to you, please call 1.800.359.9517. Applications also are available for pick up at a local DHS branch office (find a location here).
For more information, please refer to the green booklet included in your packet. The application and green booklet are available in English, Spanish, Russian and Vietnamese.
To help you prepare, here is a list of documents you may need:
- Proof of income for the current month. Copy of your most recent pay stub or a letter from your employer or the person who paid you (which must include employer's contact name and phone number). You'll need one recent pay stub for each job listed on the application.
- Self-employment income records. If you are self-employed, you'll need to send in proof of income and expenses for the last 30 days or past month. This can include payroll records, sales receipts, bookkeeping records, expense reports, etc.
- Social security card or residency card.
- Original or certified copies of citizenship documentation. Examples include a U.S. Passport, Certificate of U.S. Naturalization, U.S. Birth Certificate or American Indian Tribal Enrollment.
- Original or certified copies of identity documentation for applicants 18 and older*. Examples include a state-issued driver's license, Oregon Fish or Wildlife license, or a school ID card with the applicant's picture.
*We do not require identity documentation for children under the age of 18. The parent or guardian's signature on the application is proof of identity for children under age 18.
- Proof of American Indian/Alaska Native status.
- Private insurance card. Needed only if you have had other health coverage in the past six months.
- Proof of pregnancy. Statement from a doctor, public health department, clinic or pregnancy resource center/clinic that confirms the pregnancy.
Questions or to request an application
If you need assistance in Spanish press 2, in Russian press 3, or for all other languages press 1.
Mail applications to
OHP Processing Center
PO Box 14520
Salem, OR 97309
Fax applications to
503.373.7493 (Salem number)
You will need
- Proof of income for the current month
- Social security number or residency information
You may also need
- Private insurance card
- Self-employment income records
- Proof of American Indian/Alaska Native status
- Proof of immigration or residency status
- Proof of pregnancy