Get Or Oha 2585 2020-2026

The OR OHA 2585 form allows organizations and facilities to designate themselves as additional caregivers under the Oregon Medical Marijuana Program. This guide will provide you with step-by-step instructions on how to fill out the form online efficiently.

Follow the steps to complete the OR OHA 2585 form online.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin with the organizational or facility caregiver information section. Provide the name of the organization or facility that is providing hospice, palliative, or home health care services. Ensure the organization is licensed under the specific ORS codes mentioned.
3. Next, fill in the medical marijuana patient’s name and date of birth. This section identifies the patient for whom the organizational caregiver is being designated.
4. Complete the organization name, state licensing agency, and state license number. This information verifies the organization's legal status and authority.
5. Provide the organization’s phone number and complete address, including street address, city, state, and ZIP code.
6. Identify the person responsible for purchasing or transporting marijuana for the patient. Enter their full name (first, middle initial, and last) along with their title and date of birth.
7. Fill in the government ID number, issuing agency, and expiration date for the responsible person. This verifies their identity.
8. At the bottom of the form, confirm your authority to consent to the designation by providing your printed name, phone number, title, and signature, along with the date of signing.
9. Once all fields are completed accurately, save your changes. You may also download, print, or prepare to share the form as needed.

Complete your documents online today to streamline your process.