Individual Health
Enrollment Forms
Complete the
Enrollment Application (PDF). Only one application is necessary
per family.
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Lifewise
Individual Application
- Download Now |
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print an application simply click on the link above and
then print. Application should be
submitted at least 10 days prior to request effective
date, otherwise coverage will become effective the
following month your application has been approved. |
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Send all Enrollment Materials to:
Lifewise of Oregon
2020 SW Fourth Suite 1000
Portland, Oregon 97201
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If you have questions about
our plans, please
Contact Us. |
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