If the Non-Custodial Parent is ordered to reimburse the Custodial Parent directly for health insurance premiums, please click on the photo to the right to complete the form.  This form should be only completed if your court order does not have a specific medical support payment ordered to be paid through the State Disbursement Unit or Tarrant County Child Support Services.

Medical Chart

Medical symbol



Health care expenses include, but are not limited to, doctors' appointments, emergency room visits and prescriptions for the child/children.  If you have unreimbursed health care expenses please click on the photo to the left and complete the form.    

Accessibility Notice:
Due to the complexity of the source of the forms, the forms were created from scanned images. If you require assistance in accessing the information, please call 817-884-1879.