Submit Referrals

For Providers & Community Partners

Thank you for referring your client to Oregon Change Clinic!
Please complete both forms below and send them to us by email at office@oregonchangeclinic.com or by fax to (503) 994-5262.

Once we receive the forms, our team will follow up with both you and your client to coordinate next steps.

We proudly accept OHP (Oregon Health Plan) Medicaid insurance.

We accept OHP Medicaid health insurance plans.