Samples & Forms
Samples
Payment Disbursement Register (PDR)
Forms
Warning: Acrobat Reader does not allow you to save your completed forms; they must be printed.- Credentialing
- Recredentialing
- ODS Dental Claim
- Provider Refund Submission
- Survey of Charges - General
Dentist
- Survey of Charges
- Endodontist
- Survey of Charges
- Oral Maxillofacial Surgeon
- Survey of Charges
- Orthodontist
- Survey of Charges
- Pediatric Dentist
- Survey of Charges
- Periodontist
Brochures & Guidelines
Oral Health, Total Health Enrollment
OHP Forms
OHP Brochures & Guidelines
These resources are available for your reference and can be printed and given to OHP patients.
- Immediate Denture Brochure
This brochure will inform your patients about how to take care of immediate dentures and what to do after surgery. - Routine Visit Incentive Program - Malheur County members only en Español
This brochure provides incentives for your patients who keep up routine visits. - Talking with Your Provider* | Notes pages*
Print out this resource and note pages to help you prepare for your visit and talk with your provider. The notes pages provides questions for you to ask your provider during your next visit.
*Spanish and English versions included in document