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).


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.

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.

TVFC Form: Texas Vaccines for Children Program Patient Eligibility Screening form.

ImmTrac Newborn Registration Form

ImmTrac Texas Immunization Registry Consent Form (Minor)

ImmTrac Recien Nacido Formulario de Registro

ImmTrac Formulario De Consentimiento Para Menores