Patient Forms
Print and fill out your child(s) registration form. Once you print and fill out your form you may fax it attention:
Medical Records - (956) 425-9207 or drop it off at our clinic (321 S 21st Street).
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HPA Registration Form: Want to make your registration process quicker? Print and fill out this form and have it avilable on your visit. | ![]() |
HPA Vaccination Schedule: List of vaccines that are recommended by the American Academy of Pediatrics. |
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Medical Records Consent Form: Need to transfer your records to our clinic? Print and fill out this form. | ![]() |
HPA Policy: Our clinic's Financial Policy. |
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TVFC Form: Texas Vaccines for Children Program Patient Eligibility Screening form. | ||
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ImmTrac Newborn Registration Form | ![]() |
ImmTrac Texas Immunization Registry Consent Form (Minor) |
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ImmTrac Recien Nacido Formulario de Registro | ![]() |
ImmTrac Formulario De Consentimiento Para Menores |