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Texas vaccine information form 2026
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- Click ‘Get Form’ to open the Texas Vaccine Information Form in our editor.
- Begin by filling out the 'Information about person to receive vaccine' section. Enter the last name, first name, and middle initial of the individual receiving the vaccine, along with their birthdate and sex.
- Next, provide the address details including street, city, county, state, and zip code. Ensure all information is accurate for proper record-keeping.
- In the consent section, confirm that you agree to the vaccination by signing your name as either the recipient or an authorized guardian. Include the date of signing.
- If applicable, complete any additional fields required for clinic/office use such as clinic address and vaccine details. This ensures comprehensive documentation.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2018 | 4.8 Satisfied (91 Votes) |
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How to get an affidavit for vaccines in Texas?
You can request an affidavit through one of these methods: Via the Immunization Section Affidavit Request website. By mail. Mail to: Texas Department of State Health Services Immunization Section. By fax to (512) 776-7544. In person at: Texas Department of State Health Services.
What are the vaccine requirements in Texas?
Vaccines are a way of artificially activating the immune system to protect against infectious disease. The activation occurs through priming the immune system with an immunogen. Stimulating immune responses with an infectious agent is known as immunization. Vaccination includes various ways of administering immunogens.
What is a vaccine information statement?
Whats a VIS? A VIS or Vaccine Information Statement is a document, produced by CDC, that informs vaccine recipients or their parents or legal representatives about the benefits and risks of a vaccine they are receiving.
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People also ask
Is a Texas immunization registry required?
All healthcare providers and payors must report to ImmTrac all vaccines given to children under 18 years old.
Which immunizations are required by the state of Texas?
Vaccines: DTaP: Diphtheria, tetanus, and acellular pertussis (whooping cough); record may show DT or DTP. Polio: IPV - inactivated polio vaccine; OPV oral polio vaccine. HepB: Hepatitis B vaccine. Hib: Haemophilus influenzae type b vaccine. PCV: Pneumococcal conjugate vaccine.
How to get proof of vaccines in Texas?
To request an electronic PDF, by mail or by encrypted email, visit the public health portal. Note: Anyone over the age of 18 must request their own immunization record. An official immunization record is provided in Texas by ImmTrac2 system.
How do I access my Texas vaccine records?
Need a copy of your or your childs immunization record? Fill out the linked form and submit to ImmTrac2@dshs.texas.gov or mail to the address in the Contact section. The Texas Administrative Code sets vaccination requirements for children in public and private schools, childcare, and pre-K in Texas.
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