OHSU Vendor Registration Form

Please use this form to submit your business information to OHSU for consideration as a supplier or vendor.

Name *

Title *

Address 1 *

Address 2

City *

State *

Zip *

Email Address *

Phone *

Woman Owned – State Certified

Minority Owned – State Certified

Emerging Small Business – State Certified

Disabled Veteran’s Enterprise – Self Reported

Disadvantaged Business Enterprise – State Certified

Not Applicable