Get Tx Dshs C-96 2011-2025
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How to fill out the TX DSHS C-96 online
Filling out the TX DSHS C-96 form can be straightforward with the right guidance. This document provides you with step-by-step instructions to ensure that you complete the form accurately and efficiently.
Follow the steps to successfully complete the TX DSHS C-96 online.
- Press the ‘Get Form’ button to access the TX DSHS C-96 form and open it in your preferred editor.
- Begin by filling out the section titled 'Vaccine to be given.' Select the appropriate vaccine from the options provided — either the Meningococcal Polysaccharide Vaccine (MPSV4) or the Meningococcal Conjugate Vaccine (MCV4).
- Enter the personal details of the individual receiving the vaccine in the 'Information about person to receive vaccine' section. Include their last name, first name, middle initial, and birthdate in mm/dd/yy format.
- Provide the clinic or office address where the vaccination will take place, including street, city, county, state (TX), and zip code.
- Indicate the sex of the person receiving the vaccine by circling 'M' for male or 'F' for female.
- Complete the fields for date vaccine was administered, vaccine manufacturer, and vaccine lot number. Ensure accuracy in this information for record-keeping.
- Obtain the signature of the person receiving the vaccine or, if applicable, the parent or guardian. They must provide their signature in the designated area.
- The vaccine administrator must also sign in the specified area and indicate their title and the date of administration.
- Finally, once all the information is complete and accurately filled out, you can save changes, download, print, or share the completed form as necessary.
Complete your documentation online to ensure a smooth vaccination process.
The Tdap VIS refers specifically to the Vaccine Information Statement for the Tdap vaccine, which protects against tetanus, diphtheria, and pertussis. This document outlines the potential side effects, recommended age for administration, and the importance of vaccination. Understanding the Tdap VIS is essential for those adhering to TX DSHS C-96 requirements, ensuring you receive comprehensive vaccine information. You can find the Tdap VIS through trusted health sources and provider websites.
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