TEXAS VACCINES FOR CHILDREN PROGRAM (TVFC): PROVIDER ENROLLMENT Initial enrollment* Reenrollment (*C 2026

Get Form
tvfc enrollment Preview on Page 1

Here's how it works

01. Edit your tvfc enrollment online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send tvfc re enrollment via email, link, or fax. You can also download it, export it or print it out.

How to Use or Fill Out TEXAS VACCINES FOR CHILDREN PROGRAM (TVFC): PROVIDER ENROLLMENT Initial Enrollment & Reenrollment

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2
  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your Provider PIN Number at the top of the form. If you do not have a PIN, contact your local Health Services Region (HSR).
  3. Fill in the Responsible Entity and Name of Facility, Practice, or Clinic. Ensure all names are spelled correctly for accurate processing.
  4. Complete the Provider Name section with the last name, first name, middle initial, and title of the provider.
  5. Provide contact information including mailing address, telephone number, and email address. Double-check for accuracy to avoid communication issues.
  6. Review and agree to the terms outlined in the agreement section. Ensure that all conditions are understood before signing.
  7. Sign and date the form at the bottom. Only licensed professionals can sign this document.

Start using our platform today to streamline your enrollment process for free!

See more TEXAS VACCINES FOR CHILDREN PROGRAM (TVFC): PROVIDER ENROLLMENT Initial enrollment* Reenrollment (*C versions

We've got more versions of the TEXAS VACCINES FOR CHILDREN PROGRAM (TVFC): PROVIDER ENROLLMENT Initial enrollment* Reenrollment (*C form. Select the right TEXAS VACCINES FOR CHILDREN PROGRAM (TVFC): PROVIDER ENROLLMENT Initial enrollment* Reenrollment (*C version from the list and start editing it straight away!
Versions Form popularity Fillable & printable
2012 4 Satisfied (26 Votes)
2007 4.9 Satisfied (43 Votes)
be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
Texas law prohibits private employers from adopting or enforcing COVID-19 vaccine mandates. This law covers employees, contractors, and applicants. These restrictions are in Senate Bill 7, which added Chapter 81D to the Texas Health Safety Code. The law went into effect on February 6th, 2024.
The Texas Vaccines for Children Program (TVFC) makes vaccines available to eligible children in Texas. These vaccines are available at no cost to providers, in order to immunize eligible children (birth - 18 years of age).
To receive free vaccines through TVFC or ASN, a patient must meet eligibility requirements. Medical coverage and insurances that are accepted by the Health Department include CHIP, Medicaid, Blue Cross Blue Shield of Texas, United Health, Superior, Driscoll, and Molina.
Kindergarten Through 12th Grade Requirements Vaccine requiredKindergarten - SixthSeventh Hepatitis B2 Three doses Varicella1,2,3 Two doses Meningococcal (MCV4) 1 --- One dose Hepatitis A 1,2 Two doses3 more rows
Eligibility for Texas Vaccines for Children As of 2025, kids can get free vaccines through TVFC if they are: Medicaid Eligible: Kids who are on Medicaid. Uninsured: This means that kids dont have health insurance.

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more
ccpa2
pci-dss
gdpr-compliance
hipaa
soc-compliance
be ready to get more

Complete this form in 5 minutes or less

Get form

People also ask

Under ACA, most health plans must cover certain preventive services, including recommended vaccinations for children and teens, at no cost to you (without charging a copay or coinsurance). This is true even if you havent met your yearly deductible.

Related links