How do I request health-related services?
A request form needs to be filled out and submitted to Jackson Care Connect by email or fax. You have a couple of options:
- If you have questions or would like help filling out the application form, contact Jackson Care Connect Customer Service at info@jacksoncareconnect.org or 541-500-0567, toll-free 855-722-8208 or TTY 711.
- You can also fill out and return the form yourself, or with the help of a parent, a caregiver, or a guardian/support/trusted friend, or a staff member from an organization or clinic.
Hotel requests
Please read the following documents:
Submit forms by fax or email
- Fax: 503-416-4728
- Email: Requests.social.determinants@careoregon.org
Other flexible funding requests
Submit forms by fax or email
- Fax: 503-416-4728
- Email: Requests.social.determinants@careoregon.org