Health Care Professional Statement
Must state: “I have examined the above (named) child within the past year and find that he/she is able to take part in the day care program.” It must include child date of birth and physician’s signature and/or stamp on each page and physician/clinic contact information.
Vaccination Chart
Please see requirements here vaccination chart .
Texas Health Department requires us to have a copy of the vaccination chart with the following information:
1. Full name and DOB
2. Vaccination dates for each vaccine received
3. Physician’s signature and/or stamp on each page
4. Physician/clinic contact information
Texas law allows for an exemption from immunizations for reasons of conscience, including a religious belief. To claim an exemption due to reasons of conscience, a student's parent or legal guardian must request, sign, and submit an official DSHS affidavit form to us. The affidavit is valid for two years from the issued date.
You can request on the following link: https://corequest.dshs.texas.gov/ It might take about a week to arrive to you. Please requested as soon as possible.
Obtaining an Affidavit
A person claiming exclusion for reasons of conscience, including a religious belief, from a required immunization may only obtain the affidavit form by submitting a request (via online form, mail, fax or hand-delivery) to the Texas Department of State Health Services. The request must include following information:
Full name of child or student
Child's or student's date of birth (month/day/year)
Complete mailing address, including telephone number
View the Request for Exemption from Immunizations for Reasons of Conscience for written requests.
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