Get the free Oregon Breast and Cervical Cancer Program Enrollment Form - public health oregon
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This document serves as an enrollment form for the Oregon Breast and Cervical Cancer Program (BCCP) and the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Program,
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How to fill out Oregon Breast and Cervical Cancer Program Enrollment Form
01
Obtain the Oregon Breast and Cervical Cancer Program Enrollment Form from the official website or local health department.
02
Fill in your personal information, including name, date of birth, address, and contact details.
03
Provide information about your health insurance status and income, if applicable.
04
Answer all health-related questions accurately to determine eligibility.
05
Sign and date the form to certify that the information provided is true and complete.
06
Submit the completed form to the designated health authority or program office.
Who needs Oregon Breast and Cervical Cancer Program Enrollment Form?
01
Women aged 21 to 64 who need breast or cervical cancer screenings.
02
Individuals who are uninsured or underinsured and meet income eligibility requirements.
03
Those who have a family history of breast or cervical cancer and are in need of preventive services.
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People Also Ask about
What is the and cervical cancer program in Oregon?
The and Cervical Cancer Treatment Program (BCCTP) is a Medicaid program that gives access to the Oregon Health Plan (OHP) to uninsured or underinsured individuals in need of or cervical cancer treatment.
What are cancer patients entitled to?
United Cancer Foundation's Individual Grant Program supports people who are receiving treatment for cancer or who have been in remission for three years or less by covering expenses such as medical procedures, prescription medicines, COBRA insurance coverage, housing expenses, utilities, transportation
Do cancer patients automatically qualify for Medicaid?
2:09 2:56 And programs are available. To learn more check out these links which you can click in theMoreAnd programs are available. To learn more check out these links which you can click in the description. Below.
How to apply for BCCTP?
Apply at your County Social Services Office If your doctor told you that you have a and/or cervical cancer diagnosis, tell one of the county workers so that they can send your information to BCCTP. A BCCTP Eligibility Specialist will reach out to you directly to start an application.
Who is eligible for the Bcctp program?
You may be eligible for the BCCTP program if you: Live in California. A doctor told you that you have and/or cervical cancer and need treatment. Your monthly paycheck (gross income) is less than $2,510 before taxes are taken out for a household size of one (1) person.
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What is Oregon Breast and Cervical Cancer Program Enrollment Form?
The Oregon Breast and Cervical Cancer Program Enrollment Form is a document used to enroll eligible individuals in a state program that provides access to breast and cervical cancer screening and diagnostic services.
Who is required to file Oregon Breast and Cervical Cancer Program Enrollment Form?
Individuals who are women, aged 40 to 64, or younger women with specific symptoms, who meet income and residency criteria and require breast or cervical cancer screening services are required to file the form.
How to fill out Oregon Breast and Cervical Cancer Program Enrollment Form?
To fill out the form, applicants need to provide personal information such as their name, address, date of birth, insurance status, income, and respond to questions regarding their health history and eligibility.
What is the purpose of Oregon Breast and Cervical Cancer Program Enrollment Form?
The purpose of the form is to determine eligibility for the Breast and Cervical Cancer Program, which aims to provide necessary screenings and diagnostic services to women at risk for breast and cervical cancers.
What information must be reported on Oregon Breast and Cervical Cancer Program Enrollment Form?
The information that must be reported includes personal identification details, income level, insurance status, and any relevant medical history or symptoms related to breast or cervical health.
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