Helpful Forms & Links
Below are some helpful forms and links to other websites that may help you get well and stay well.
Forms
- Authorization to Disclose Health Information Form (Electronic)
- Authorization to Disclose Health Information – Cancellation Form (PDF)
- Asthma Form (PDF)
- Change of Provider Request Form (PDF)
- COPD Form (PDF)
- Coronary Artery Disease Form (PDF)
- Diabetes Form (PDF)
- Doctor Appointment Checklist (PDF)
- Express Scripts Pharmacy Member Portal
- High Blood Pressure Form (PDF)
- High Cholesterol Form (PDF)
- Primary Care Provider (PCP) Change Request Form (PDF)
- Weight Management Form (PDF)
To help you make sure your child’s doctor has the information he or she needs when you visit, please fill out one of the forms below before you go to an appointment:
- 2-Month-Old Child Well-Visit Form (PDF)
- 4-Month-Old Child Well-Visit Form (PDF)
- 6-Month-Old Child Well-Visit Form (PDF)
- 9-Month-Old Child Well-Visit Form (PDF)
- 12-Month-Old Child Well-Visit Form (PDF)
- 15-Month-Old Child Well-Visit Form (PDF)
- 18-Month-Old Child Well-Visit Form (PDF)
- 24-Month-Old Child Well-Visit Form (PDF)
- 30-Month-Old Child Well-Visit Form (PDF)
- 3-Year-Old Child Well-Visit Form (PDF)
- 4-Year-Old Child Well-Visit Form (PDF)
- 5-Year-Old Child Well-Visit Form (PDF)
- 6-Year-Old Child Well-Visit Form (PDF)
- 7-Year-Old Child Well-Visit Form (PDF)
- 8-Year-Old Child Well-Visit Form (PDF)
- 9-Year-Old Child Well-Visit Form (PDF)
- 10-Year-Old Child Well-Visit Form (PDF)
Helpful Links
Below are some helpful resources you can use to find more information that may help you get well and stay well. Please note, these links will take you away from Superior’s website.
- AARP - American Association of Retired Persons
- Academy of Nutrition and Dietetics
- American Academy of Pediatrics – HealthyChildren.org
- American Cancer Society
- American Heart Association
- American Lung Association
- BabyCenter.com
- Centers for Disease Control and Prevention
- Centers for Medicare and Medicaid Services (CMS)
- Children’s Advocacy of Texas
- CMS Best Available Evidence Policy
- Commercially Sexually Exploited Youth (CSEY) Advocacy (PDF)
- Program Locations/Partners (PDF)CTI-EBP Fair Housing and Reasonable Accommodations (Online Training)
- Cystic Fibrosis Foundation
- Department of Family and Protective Services (DFPS)
- Electronic Visit Verification (EVV) Frequently Asked Questions (PDF)
- Electronic Visit Verification (EVV) Responsibilities and Additional Information Form 1718 (PDF)
- Electronic Visit Verification (EVV) Rights and Responsibilities (PDF)
- Electronic Visit Verification (EVV) Policy Training Portal
- Financial Literacy Guide (Office of Consumer Credit Commission)
- Friends and Family Guide to Adult Mental Health Services
- Health and Human Services Commission (HHSC) Day Activity and Health Services (DAHS) Form – 3050
- Health and Human Services Commission (HHSC) Day Activity and Health Services (DAHS) Form - 3052
- Hemophilia Foundation of America
- Housing Support Resources (PDF)
- ImmTrac – Texas Immunization Registry
- Kids Health from Nemours
- March of Dimes
- Mayo Clinic
- Medically Dependent Children Program (MDCP)
- National Imaging Associates (NIA) RadMD
- National Institute of Mental Health - Disruptive Mood Dysregulation Disorder (DMDD) (PDF)
- Nutrition.gov
- Office of the Inspector General (OIG) – Report Fraud, Waste or Abuse
- Office of the Texas Governor – Child Sex Trafficking Team: Commercially Sexually Exploited Youth (CSEY) Advocacy crisis response and support flyer (PDF)
- Sickle Cell Disease Association of America
- Siteman Cancer Center – Your Disease Risk
- Social Security Administration (SSA)
- STAR Kids and STAR+PLUS Service Comparison flyer (PDF)
- STAR Kids Transition Assistance Services Brochure (PDF)
- STAR+PLUS Health & Human Services Commission (HHSC) website
- STAR+PLUS Personal Assistance Services (PAS) Brochure (PDF)
- STAR+PLUS Service Coordination and Benefits for Individuals with an Intellectual Developmental Disability or Related Condition Brochure (PDF)
- STAR Health Managed Care Contract
- Susan G. Komen for the Cure – About Breast Cancer
- Texas Department of State Health Services
- Texas Foster Family Association (TFFA)
- Texas Health and Human Services Commission
- Texas Health and Human Services Notice about Reporting Medicaid Fraud (PDF)
- The Children’s Health Insurance Program (CHIP)
- The Hotline
- The Trevor Project
- U.S. Department of Health & Human Services – healthfinder.gov
- U.S. Department of Agriculture – ChooseMyPlate.gov
- U.S. Department of Veterans Affairs
- United Way of Austin