We provide comprehensive healthcare services to Hillsboro and surrounding communities.

Forms

THA requires the following forms to be submitted to request a referral to a non-THA specialist, a non-formulary medication, or medical equipment. For help with any of these forms, please call our Referral Coordinators at: 503-844-8104.

THA PCP/Specialist Referral Form 

This form must be used for all THA member referrals and procedure pre-authorizations. The form must be filled out completely and accurately to ensure timely processing. The form should include at a minimum:

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THA Drug Prior Authorization Form

This form must be used for all THA member medication pre-authorizations. The form must be filled out completely and accurately to ensure timely processing. The form should include at a minimum:

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THA Durable Medical Equipment Prior Authorization Form

This form must be used for all THA member medical equipment pre-authorizations. The form must be filled out completely and accurately to ensure timely processing. The form should include at a minimum:

Download THA Durable Medical Equipment Prior Authorization Form (PDF) »