Steps To Becoming A Client

There are three steps to becoming a client. The Intake Coordinator is here to help you through this process:

Step 1: Intake

Call 541-342-5088 or Toll Free 1-866-470-3419 and ask for an Intake Coordinator.
Schedule an appointment for enrollment via walk in or by phone.
Complete and return intake paperwork
Provide information about where we can obtain HIV verification for you
Provide the following:
- Income Verification
  - Work income (2 months current, consecutive pay stubs or earnings statements for ALL jobs)
  - Self-employment income (most recent quarterly tax returns or business records for the most recent 3 consecutive months)
  - Unemployment benefits (compensation stubs)
  - Disability benefits (award letter)
  - Stocks, bonds, cash dividends, trust, investment income, royalties (documentation from financial institution showing income received, values, terms, and conditions)
  - Alimony/Child support, foster care payments (benefit award letter or official document showing amount received regularly)
  - Pension or retirement income (not SSI) (annual benefit statement)
  - Social Security retirement/survivor’s benefits (annual benefit statement)
  - Veterans benefits (benefit award letter)
  - Social Security Income (SSI/SSDI) (annual benefit statement)
  - Public Assistance (not SNAP or LIHEAP) (most recent payment statement or benefit notice)
  - Worker’s Compensation or sick benefits (benefit award letter)
- Proof of Residency
  - One of the Following:
    - Unexpired Oregon Driver License
    - Unexpired Tribal ID
    - Unexpired Oregon State ID
    - Utility bill (cell phone bills not accepted)
    - Lease, rental, mortgage, or moorage agreement
    - Most recent property tax document
    - Residency Verification Form (will be provided only if no other form of documentation
  - OR Two of the Following:
    - Copy of SSI/SSDI Award
    - Copy of public assistance document (SNAP, OHP, etc.)
    - Current Oregon Voter Registration Card
    - Pay-stubs showing the employee’s home address
    - Documents issued by a financial institution (bank statement, credit card bill)
    - Court Corrections Proof of Identity
    - Homeowner’s Association fee
    - Military/Veteran’s Affairs
    - Oregon vehicle title or registration card
    - Approved letter from Oregon State Hospital, homeless shelter, transitional service provide

Step 2: Care Coordination Screening

This is a chance to meet with your Care Coordinator to talk about your needs and create a plan for your care. The Intake Coordinator will schedule this with you.

Step 3: RN Health Assessment

The RN will talk with you about your health and answer questions. Together you will identify ways to improve your wellness. The Intake Coordinator will schedule this with you.