Download and fill out the activation form - Texas Childrens Hospital - texaschildrenshospital 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your name, date of birth, and any previous names if applicable in the Parent/Guardian/Spouse information section.
  3. Indicate whether you have been seen or treated at any Texas Children’s Hospital facility by selecting 'Yes' or 'No'.
  4. Fill in your current address, including city, state, and zip code. Provide both home and work phone numbers.
  5. If your address differs from the one provided, complete the alternate address fields.
  6. Enter your email address for communication purposes.
  7. Review the authorization section carefully. Ensure you understand your rights regarding access to protected health information before signing.
  8. Sign and date the form at the bottom. Make sure to indicate your authority to sign if you are not the patient.
  9. Complete the Patient information section by providing the patient's name, MRN, previous names, date of birth, and relationship to the patient.

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