The Texas Health Steps Provider Outreach Referral Form should be used by all Texas Health Steps providers who submit a request for outreach on behalf of a Texas Health Steps patient as it replaces the Texas Health Steps Missed Appointment Referral Form.
Texas Health Steps providers may use the referral form when submitting a request for outreach through the Texas Health Steps Provider Outreach Referral Service. This service, previously known as the Texas Health Steps Missed Appointment Referral Service, should be used when a Texas Health Steps patient needs to be seen for a follow-up, needs to have a missed appointment rescheduled, needs assistance scheduling transportation, or requires other patient-related outreach services.
The links below can be used to download the referral form and an instruction guide for completing the form. The referral form comes in two versions – Microsoft Word and Portable Document Format (PDF) – both of which can be completed by hand or electronically online.
Texas Health Steps providers who have questions about this new referral form, or need information about the Texas Health Steps Provider Outreach Referral Service, should contact the appropriate Texas Health Steps provider relations representative in their region. The names and contact information of the representatives can be found at http://www.dshs.state.tx.us/thsteps/regions.shtm
. Texas Health Steps Provider Outreach Referral Form
[Word 133KB] Texas Health Steps Provider Outreach Referral Form
[PDF 1.01MB] Instructions