US Family Health Plan

Change & Reimbursement Forms

• Allotment Form (PDF)
• Primary Care Physician Change Form (PDF)
• Reimbursement Request (PDF)

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Enrollment Applications

• Enrollment Form & Instructions (PDF)
• TRICARE Young Adult Enrollment Application (PDF)

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Legal Documents

• Form 2001: Notification of Appointment of Personal Representative (PDF)
• TX Out-of-hospital DNR (PDF)
• TX Statutory Advance Medical Directive (PDF)
• TX Statutory Durable Power of Attorney (PDF)
• US Family Health Plan Privacy Notice (PDF)

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Member Resources

• Child Well-care and Immunization Recommendations (PDF)
• Member Handbook (PDF)

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Pharmacy Resources

• Mail Order Form (PDF)
• New Patient Questionnaire – Maxor Pharmacy (PDF)
• Maxor Pharmacy Benefits Booklet 

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Provider & Pharmacy Directory

Provider Search Tool

• Online Searchable Provider Directory

Provider Search Tool

• USFHP Provider Directory (PDF)

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If you don’t see what you’re looking for, contact us or call 1-844-282-3100. We can help you find the plans, forms and resources you need.