Get Tx Dshs Form C-7 2012

Filling out the TX DSHS Form C-7 online can streamline the process of registering your child's immunization records with the Texas Department of State Health Services (DSHS). This guide provides step-by-step instructions to ensure that you complete the form accurately and efficiently.

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 preferred editor.
2. Begin by entering the child's last name, middle name, and first name in the respective fields.
3. Select the child's gender by marking either 'Male' or 'Female'.
4. Input the child's date of birth in the provided format.
5. Fill in the child’s address, including apartment number, city, state, and zip code.
6. Enter the mother’s first name and maiden name as required.
7. Provide a telephone number where you can be reached.
8. Indicate the county of residence.
9. Read through the consent section carefully, ensuring that you understand the implications of enrolling your child in the ImmTrac registry.
10. Sign and date the form where indicated to grant consent.
11. Make sure to print your name clearly below your signature.
12. Once all fields are completed, save your changes, and download or print the form as necessary.
13. Submit the finished form by faxing or mailing it to the DSHS ImmTrac Group or a registered healthcare provider.

Complete your TX DSHS Form C-7 online today for a secure and efficient way to manage your child's immunization records.