Referral Form

Currently, we are only able to provide services to Superior Health Plan Members who live in the San Antonio Area

AGE

The youth must be at least three years of age or older.

MEDICAID

The youth must be enrolled in Medicaid and one of our excepted provider plans listed in the chart below

COUNTY

The youth must reside in a county where our services or provided below.

DIAGNOSED

The youth must have a qualifying mental health diagnosis and undergo an initial assessment by our provider

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