IMMUNIZATION REGISTRY (ImmTrac2) Minor Consent Form (Please print clearly) Childs First NameChilds Middle NameChilds Date of Birth (mm/dd/yyyy) Childs Address City*Children younger than 18 years old.

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How to fill out the TX DSHS Form C-7 online

The TX DSHS Form C-7 is a crucial document for registering your child in the Texas immunization registry, ImmTrac2. This guide provides detailed instructions on how to complete the form online, ensuring a smooth and user-friendly experience.

Follow the steps to complete the TX DSHS Form C-7 online.

  1. Press the ‘Get Form’ button to access the TX DSHS Form C-7 and open it in your chosen editor.
  2. Begin by entering your child's first and middle names in the designated fields, ensuring you print clearly for accuracy.
  3. Fill in your child's date of birth using the format mm/dd/yyyy. This section is essential for identifying your child’s immunization records.
  4. Provide your child's last name, followed by selecting their gender by marking either 'Female' or 'Male.'
  5. Enter your child's complete address, including apartment number (if applicable), city, state, and zip code to maintain accurate records.
  6. Fill in the mother’s first name, phone number, and email address, ensuring that all contact information is current for effective communication.
  7. Input the county and the mother's maiden name in the respective sections to assist in processing the form.
  8. Select all applicable races from the list provided. This information helps in compiling demographic statistics.
  9. Choose your child's ethnicity by selecting one option from the predefined categories. This part is crucial for data collection.
  10. Review the consent statement to understand the implications of registering your child's immunization records. If you agree, proceed to provide your printed name, the date, and your signature.
  11. Once all fields are completed, you can save changes, download the form, print it for your records, or share it with designated entities as necessary.

Start filling out the TX DSHS Form C-7 online today to ensure your child's immunization records are properly registered.

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