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 PortalExternal Link
- 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 PersonsExternal Link
- Academy of Nutrition and DieteticsExternal Link
- American Academy of Pediatrics – HealthyChildren.orgExternal Link
- American Cancer SocietyExternal Link
- American Heart AssociationExternal Link
- American Lung AssociationExternal Link
- BabyCenter.comExternal Link
- Centers for Disease Control and PreventionExternal Link
- Centers for Medicare and Medicaid Services (CMS)External Link
- Children’s Advocacy of TexasExternal Link
- CMS Best Available Evidence PolicyExternal Link
- Commercially Sexually Exploited Youth (CSEY) Advocacy (PDF)External Link
- Program Locations/Partners (PDF)CTI-EBP Fair Housing and Reasonable Accommodations (Online Training)External Link
- Cystic Fibrosis FoundationExternal Link
- Department of Family and Protective Services (DFPS)External Link
- Electronic Visit Verification (EVV) Frequently Asked Questions (PDF)
- Electronic Visit Verification (EVV) Responsibilities and Additional Information Form 1718 (PDF)External Link
- Electronic Visit Verification (EVV) Rights and Responsibilities (PDF)External Link
- Electronic Visit Verification (EVV) Policy Training PortalExternal Link
- Financial Literacy Guide (Office of Consumer Credit Commission)External Link
- Friends and Family Guide to Adult Mental Health Services External Link
- Health and Human Services Commission (HHSC) Day Activity and Health Services (DAHS) Form – 3050External Link
- Health and Human Services Commission (HHSC) Day Activity and Health Services (DAHS) Form - 3052External Link
- Hemophilia Foundation of AmericaExternal Link
- Housing Support Resources (PDF)
- ImmTrac – Texas Immunization RegistryExternal Link
- Kids Health from NemoursExternal Link
- March of DimesExternal Link
- Mayo ClinicExternal Link
- Medically Dependent Children Program (MDCP)External Link
- National Imaging Associates (NIA) RadMDExternal Link
- National Institute of Mental Health - Disruptive Mood Dysregulation Disorder (DMDD) (PDF)External Link
- Nutrition.govExternal Link
- Office of the Inspector General (OIG) – Report Fraud, Waste or AbuseExternal Link
- Office of the Texas Governor – Child Sex Trafficking Team: Commercially Sexually Exploited Youth (CSEY) Advocacy crisis response and support flyer (PDF)External Link
- Sickle Cell Disease Association of AmericaExternal Link
- Siteman Cancer Center – Your Disease RiskExternal Link
- Social Security Administration (SSA)External Link
- STAR Kids and STAR+PLUS Service Comparison flyer (PDF)
- STAR Kids Transition Assistance Services Brochure (PDF)
- STAR+PLUS Health & Human Services Commission (HHSC) websiteExternal Link
- 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 ContractExternal Link
- Susan G. Komen for the Cure – About Breast CancerExternal Link
- Texas Department of State Health ServicesExternal Link
- Texas Foster Family Association (TFFA)External Link
- Texas Health and Human Services CommissionExternal Link
- Texas Health and Human Services Notice about Reporting Medicaid Fraud (PDF)
- The Children’s Health Insurance Program (CHIP)External Link
- The HotlineExternal Link
- The Trevor ProjectExternal Link
- U.S. Department of Health & Human Services – healthfinder.govExternal Link
- U.S. Department of Agriculture – ChooseMyPlate.govExternal Link
- U.S. Department of Veterans AffairsExternal Link
- United Way of AustinExternal Link