PEBB Health Insurance Forms |
PEBB Enrollment, Update, and Beneficiary Forms |
PEBB Appeal Form |
Health Insurance Reimbursement Forms |
PEBB Statewide Plan Forms (Providence) (Includes Medical Claim Form, Prescription drug claim form, prescription drug prior authorization form, etc) |
Providence Choice Forms |
Moda Medical & Dental Forms |
Flexible Spending Account Claim Forms (Healthcare and Dependent Care) (.pdf file) |
Flexible Spending Account - Other Forms |
VSP Reimbursement Form (.pdf file) |
Family & Medical Leave |
Medical Certification Form (.pdf file) |
Tuition Reduction (Staff Fee Privileges) |
Staff Fees Form - Employee |
Staff Fees Form - Family Transfer |
Retirement Savings - Tax Deferred Investment and Savings Plan |
TDI 403(b) Voluntary Savings Forms:
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Oregon Savings Growth Plan (457) Forms |
Oregon Savings Growth - Online Enrollment |
Oregon Savings Growth Plan – Make Change to Monthly Contribution |
Public Employees Retirement System (PERS) |
Beneficiary, Withdrawal, Retirement Forms - Tier 1, Tier 2, IAP |
Beneficiary, Withdrawal, Retirement Forms - OPSRP, IAP |
Retiree Health Insurance Enrollment Forms |
PEBB Retiree Health Insurance Application |
PEBB Retiree Pay Type Option Form - submit with PEBB Retiree Application |
PERS Health Insurance Forms |
Workers' Compensation Forms |
Office of Insurance and Risk Management Services website |
Workers' Compensation forms |
OSU Report of Accident (web form) |
Important Information for Employees with Occupational Injuries (.pdf file) |
Continued Benefits for Injured Workers Notice (.pdf file) |