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DocuSign Envelope ID: 0D3853DC9D2F488BA29240824843EA10FORM A STATEMENT REGARDING THE ACQUISITION OF CONTROL OF OR MERGER WITH A CCO Columbia Pacific CCO, LLC and Jackson County CCO, LLC d/b/a Jackson
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The Oregon Health Authority form is a document used to report health information to the state of Oregon.
Healthcare providers, facilities, and organizations in Oregon are required to file the Oregon Health Authority form.
To fill out the Oregon Health Authority form, you will need to provide information about the health services provided, patient demographics, and other relevant data.
The purpose of the Oregon Health Authority form is to collect and analyze health data to improve public health initiatives and services.
Information such as patient demographics, health services provided, and any relevant health outcomes must be reported on the Oregon Health Authority form.
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