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Get Tx Ec-94 2014-2026

Texas Department of State Health Services Addendum to TD (Tetanus and Diphtheria) Vaccine Information Statement1. I agree that the person named below will get the vaccine checked below. 2. I received.

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How to fill out the TX EC-94 online

The TX EC-94 form is essential for consenting to the Tetanus and Diphtheria (Td) vaccine. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently online.

Follow the steps to fill out the TX EC-94 online.

  1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
  2. Begin by entering the name of the person who will receive the vaccine in the designated fields: Last name, First name, and Middle initial.
  3. Fill in the birthdate of the individual receiving the vaccine using the format mm/dd/yy.
  4. Indicate the sex of the individual by circling either M for Male or F for Female.
  5. Provide the address information including Street, City, County, and State (TX). Ensure the Zip code is also filled in correctly.
  6. If you are not the individual receiving the vaccine, provide the signature of the person who is consenting, or the signature of a parent or guardian if applicable.
  7. Date the signature to indicate when consent was given.
  8. A witness must sign and date the form in the designated area.
  9. The vaccine administrator must print their signature and include their title in the corresponding fields.
  10. Once all fields are completed, review the form for accuracy. You can then save your changes, download, print, or share the form as needed.

Complete your documents online to ensure a smooth vaccination process.

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