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Other Forms

Covering Others

  • Affidavit of Domestic Partnership
  • Domestic Partner Tax Status
  • Domestic Partnership Termination
  • Affidavit of Dependency
  • Grandchild by Affidavit

Miscellaneous Forms

  • PEBB Appeal Form
  • Prescription Prior Authorization Form

Life Insurance and Long Term Care

  • Medical History Statement for Optional Life Insurance (paper form)
  • Medical History Statement for Optional Life Insurance (complete and submit online)
  • Standard Life Insurance Portability Form
  • Transfer  of Premium Payment for Life Insurance and Long Term Care

Visit the PEBB Forms Library for access to all forms.

PEBB Forms Library

Human Resources

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  • Payroll Services Banner Guide
  • Oregon Public Universities Retirement Plans

Contact Us

Human Resources
677 East 12th Ave.
5210 University of Oregon
Eugene , OR 97403-5210

P: 541 346-3159 F: 541 346-2548

hrinfo@uoregon.edu

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University of Oregon
© University of Oregon.  All Rights Reserved.

UO prohibits discrimination on the basis of race, color, sex, national or ethnic origin, age, religion, marital status, disability, veteran status, sexual orientation, gender identity, and gender expression in all programs, activities and employment practices as required by Title IX, other applicable laws, and policies. Retaliation is prohibited by UO policy. Questions may be referred to the Title IX Coordinator, Office of Affirmative Action and Equal Opportunity, or to the Office for Civil Rights. Contact information, related policies, and complaint procedures are listed on the statement of non-discrimination.

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