Vaccine Forms


Parents,

If your student has received a notice for a vaccine due please fill out the following forms.

* Please choose from the vaccine due forms below. Your letter should state the vaccines.

* Eligibility and Immtrac form must also be returned.

* Each immunization is $10. Checks or cash. Checks payable PISD School Nurses Fund.

1.Vaccine forms-

Please print and fill out the form(s) that pertain to your child's required vaccine(s). http://www.dshs.state.tx.us/Layouts/ContentPage.aspx?PageID=34562&id=29698&terms=VIS+FORM

IF YOU HAVE PRIVATE HEALTH INSURANCE YOU ARE NOT ELIGIBLE. Medicare, Medicaid, CHIP, No health insurance, American Indian, American Eskimo ARE ELIGIBLE.

3. IMMTRAC ELIBILITY https://www.immtrac.tdh.state.tx.us/info/ConsentForm_C7_en.pdf


Click here to download the Parents Guide to Vaccine-Preventable Diseases and Childhood Vaccines

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