Forms

All City of Portland employees can use these forms for reimbursement of a covered service from a provider that DID NOT bill us directly:

• Medical and vision claim form
• Dental claim form

City of Portland firefighters can get their annual NFPA 1582 physical at no cost. Firefighters should complete sections 1 and 3 of the following claims form.

• City of Portland Medical Claims Form PFFA

Once completed, send them to our team using one of the following methods:

• Mail: P.O. Box 40384 Portland, OR 97240
• Fax: 855-522-9809