• Breast and Cervical
• Contractor Vouchers and Reporting
• County Indigent Health Care Program
• Epilepsy Forms
• Epilepsy Manual (PDF)
• Family Planning
• Household Eligibility Workhseet
• Primary Health Care Forms
• Primary Health Care Manual (PDF)
• Title V MCH Fee for Service Forms
• Title V MCH Fee for Service Manual (PDF)

Note: These files are in Excel format unless otherwise noted.

• FY19 Title V Child Dental Reimbursement Worksheet
• FY19 Title V Child Health Reimbursement Worksheet
• FY19 Title V Prenatal Dental Reimbursement Worksheet
• FY19 Title V Prenatal Medical Reimbursement Worksheet

Note: These files are in Excel format unless otherwise noted.

• FY17 PHC Budget Forms
• FY17 Title V Child Dental Reimbursement Worksheet
• FY17 Title V Child Health and Dental Application (MS Word)
• FY17 Title V Child Health Reimbursement Worksheet
• FY17 Title V Prenatal Dental Reimbursement Worksheet
• FY17 Title V Prenatal Medical and Prenatal Dental Renewal (MS Word)
• FY17 Title V Prenatal Medical Reimbursement Worksheet

Health Service Region 1

• Sheila Rhodes, RN, 806-783-6485, Fax: 806-783-6430
• Keila Johnson, RN, 806-477-1113, Fax: 806-655-7159

Health Service Region 2/3

• Chrysanne Randal, 940-888-8019, Fax: 940-888-3364
• Laticcia Riggins, 817-264-4658, Fax: 817-264-4555

Health Service Region 4/5N

• Della Mendez, 903-533-5334; Fax: 903-533-5367

Health Service Region 6/5S

• Waseem Ahmed, 713-767-3000 ext. 3011, Fax: 713-767-3038

Health Service Region 7

• Chesca Thurman, 254-778-6744 ext. 2322, Fax: 254-778-6819
• Mary Pierce, RN, 512-321-3982
• Glenna Tucker, RN, 512-556-5421

Health Service Region 8

• Jacinto (Jay) Medellin, RN, 210-949-2081, Fax: 210-949-2084

Health Service Region 9/10

• Pam Celaya-Flores, 432-837-3877, Fax: 432-837-5523

Health Service Region 11

• Anna Weaver, 956-421-5578, Fax: 956-444-3251
• Lupita Cazares, 956-423-0130 ext. 549, Fax: 956-444-3216 or 3299

For further information regarding the health service regions, visit the regional websites.