DSHS Immunization Publications Online Order Form

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2. Publication Order Information

Note: Please order from Immunization Unit-Literature and Forms once a month and only order up to the quantity limits. Thank you for your cooperation. Contact Clara Taylor at clara.taylor@dshs.texas.gov to inquire about ordering quantities of materials larger than the stated limits.

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Available Online Only = Out of stock - Product is available as PDF for download and for customers to make copies to distribute while out of stock.

Note: May 1, 2006, the Texas Department of State Health Services, Immunization Unit, Literature and Forms no longer accepts back orders for publications currently not available due to revisions/replenishments. Please check with the Immunization Unit, Literature and Forms at (800) 252-9152 extension 6530 on the availability of publications not available.

Publication Stock #	Publication Title	Revision Date	Notes	Quantity
6-14	2017–2018 Minimum State Vaccine Requirements for Texas School Entrance/Attendance - Bilingual (PDF)	03/2017	Valid for School Year 2017–2018 8½″ × 11″, 4pp.	Available Online Only
6-15	2017–2018 Minimum State Vaccine Requirements for Texas Child-Care Facilities - Bilingual (PDF)	03/2017	Valid for School Year 2017–2018 8½″ × 11″, 4pp.	Maximum Limit: 5000
6-26P	Recommendation for Handling & Storage of Selected Biologicals-Poster - English (PDF)	10/2014	17″ × 33½″ Poster	Maximum Limit: 15
6-27P	"How to Administer Injections" Poster - Bilingual (PDF)	09/2007	13″ × 27″ Poster	Available Online Only
6-30	Communicable Disease Chart & Notes for Schools & Child Care Center Poster - English (PDF)	03/2013	22″ × 30″ Poster	Maximum Limit: 100
6-36	Fee for Vaccine Administration Poster - English (PDF)	08/2009	17″ × 22″ Poster	Maximum Limit: 50
6-61	Contraindications and Precautions-Poster - English (PDF)	04/2014	19″ × 27″ Poster	Currently Not Available
6-67	Story of Shots Booklet - English (PDF)	06/2009	N/A	Currently Not Available
6-67A	Story of Shots Booklet - Spanish (PDF)	06/2009	N/A	Currently Not Available
6-102	Texas Vaccines For Children Physician Recruitment Packet - English (PDF)	03/2014	Please contact your Health Service Region (HSR) representative to obtain a copy or download from the TVFC website.	Available Online Only
6-103	Texas School Immunization Law - English (PDF)	07/2012	N/A	Currently Not Available
6-104	Recommended Adult Immunization Schedule, United States, 2017 - English (PDF)	01/2017	17" X 11"	Maximum Limit: 50
6-104A	Recommended Adult Immunization Schedule, United States, 2016 - Spanish	01/2016	17″ × 11″	Currently Not Available
6-104L	Recommended Adult Immunization Schedule, United States, 2017, Laminated - English	01/2017	17" X 11"	Maximum Limit: 50
6-104PSS	Recommended Adult Immunization Schedule, 2016, Pocket Size - English (PDF)	01/2016	4″ × 5″	Currently Not Available
6-105	Recommended Immunization Schedules for Persons Aged 0 – 18 Years, United States, 2017 - English (PDF)	01/2017	11" x 8.5"	Maximum Limit: 50
6-105A	Recommended Childhood and Adolescent Immunization Schedule, United States, 2016 - Spanish (PDF)	10/2016	N/A	Currently Not Available
6-105L	Recommended Immunization Schedules for Persons Aged 0 – 18 years, United States, 2017, Laminated - English	01/2017	N/A	Maximum Limit: 50
6-105PSS	Recommended Immunization Schedules for Persons Aged 0 – 18 years, United States, 2016, Pocket Size - English (PDF)	01/2016	N/A	Currently Not Available
6-180	Refrigerator Warning Signs for Vaccine Storage - Bilingual (PDF)	08/2016	N/A	Maximum Limit: 50
6-202	ImmTrac Brochure, “Love Them & Protect Them” - Bilingual (PDF)	04/2015	N/A	Available online only
6-202P	ImmTrac Poster, “Love Them & Protect Them” - Bilingual (PDF)	05/2005	11″ × 25⅜″ Poster	Maximum Limit: 25
6-218	ImmTrac Provider Brochure, “Protect Texans” - English (PDF)	08/2016	N/A	Maximum Limit: 250
6-250	General Recommendations on Immunization. Morbidity and Mortality Weekly Report (MMWR) January 28, 2011/Vol. 60/No. 2. - English (PDF)	01/2011	N/A	Available Online Only
6-251	Standards for Child and Adolescent Immunization Practices - English (PDF)	07/2004	N/A	Available Online Only
6-252	Standards for Adult Immunization Practices - English (PDF)	05/2008	N/A	Available Online Only
11-11117	TVFC Brochure (Parents), “I’m invincible!” - Bilingual (PDF)	10/2014	N/A	Available online only
11-11166	“Vaccines Provide Protection When Your Baby Needs It Most” Poster - Bilingual (PDF)	10/2014	N/A	Available Online Only
11-11444	“Hepatitis B Vaccine Can Save your Baby's Life” Poster - Bilingual (PDF)	07/2016	18″ × 11″ Poster	Maximum Limit: 100
11-12155	Giving All the Doses Chart - Bilingual (PDF)	05/2017	17" X 11"	Maximum Limit: 25
11-12811	“Little Kids Get the Flu Too!” Brochure - English (PDF)	10/2013	N/A	Available online only
11-12811A	“Little Kids Get the Flu Too!” Brochure - Spanish (PDF)	05/2011	N/A	Available online only
11-12812	Influenza Fact Sheet for Child-Care Settings - Bilingual (PDF)	07/2015	N/A	Maximum Limit: 250
11-12815	Vaccines Full Protection Magnet - English (PDF)	01/2017		Maximum Limit: 125
11-12815A	Vaccines Full Protection Magnet - Spanish (PDF)	01/2017		Maximum Limit: 125
11-12816	“Comfort Measures” Tear Off Sheets (Pads of 50 Sheets ea.) - Bilingual (PDF)	10/2007	N/A	Available Online Only
11-12816P	“Comfort Measures” Poster - Bilingual (PDF)	10/2007	19″ × 25″ Poster	Maximum Limit: 25
11-12845P	“Good Health Can Last a Lifetime” Poster - Bilingual	03/2011	11″ × 17″ Poster	Currently Not Available
11-12849	Adolescent Immunization Program Brochure - Bilingual	02/2013	N/A	Currently Not Available
11-12851	“Vaccinate For Life” Brochure - Bilingual (PDF)	08/2011	N/A	Currently Not Available
11-12853P	“Vaccinate for Life” Poster - Bilingual	08/2011	11″ × 17″ Poster	Currently Not Available
11-13079	First Responders ImmTrac Brochure - English (PDF)	01/2009	N/A	Maximum Limit: 50
11-13080P	First Responders Immtrac Poster - English (PDF)	11/2008	22″ × 16″ Poster	Maximum Limit: 25
11-13132	“Good Health Can Last a Lifetime” Adolescent Bookmark - Bilingual	08/2013	N/A	Currently Not Available
11-13175M	Immunization Schedule Magnet (BABY BEBA - Photo Frame Magnet) - Bilingual (PDF)	12/2016	5 1/2" x 8 1/2"	Maximum Limit: 125
11-13231	"Vaccines & Me" Coloring Calendar 2014-2015 (Bilingual) Rev. 12/2013	12/2013	N/A	Currently Not Available
11-13539	ImmTrac Adult Consent Brochure - Bilingual (PDF)	05/2011	N/A	Available Online Only
11-13546	Additional Information Regarding Registry Benefits - Bilingual (PDF)	10/2016	N/A	Maximum Limit: 250
11-13547P	“Recommended Vaccines for Children Birth to 12 Years of Age” Poster - Bilingual (PDF)	01/2011	22″ × 17″ Poster	Maximum Limit: 10
11-13548	Recommended Vaccines Equal Full Protection Banner - Bilingual (PDF)	03/2011	17″ × 54″ Poster	Currently Not Available
11-13643	“Protect Two from the Flu” Brochure - Bilingual (PDF)	06/2011	N/A	Maximum Limit: 500
11-13645P	“Protect Two from the Flu” Poster - Anglo - English (PDF)	06/2011	N/A	Maximum Limit: 25
11-13645P-2	“Protect Two from the Flu” Poster - African American - English (PDF)	06/2011	N/A	Maximum Limit: 25
11-13645PA	“Protect Two from the Flu” Poster - Latino - Spanish (PDF)	06/2011	N/A	Maximum Limit: 25
11-13654P	Pertussis Cocooning Poster - Bilingual (PDF)	04/2013	24″ × 18″ Poster	Maximum Limit: 25
11-13655	Pertussis Cocooning Brochure - Bilingual (PDF)	01/2016	N/A	Maximum Limit: 500
11-13707	“ImmTrac Isn’'t Just For Kids” Brochure - English (PDF)	12/2011	N/A	Available Online Only
11-13707A	“ImmTrac Isn't Just for Kids” Brochure - Spanish (PDF)	04/2012	N/A	Maximum Limit: 500
11-13707P	“ImmTrac Isn’'t Just For Kids” Poster-African American Adults - Bilingual (PDF)	12/2011	9¼″ × 12¼″ Poster	Available Online Only
11-13707P-2	“ImmTrac Isn’'t Just For Kids” Poster-Anglo Adults- Bilingual (PDF)	12/2011	9¼″ × 12¼″ Poster	Maximum Limit: 25
11-13707P-3	“ImmTrac Isn’'t Just For Kids” Poster-Hispanic Adults - Bilingual (PDF)	12/2011	9¼″ × 12¼″ Poster	Maximum Limit: 25
11-13708	“ImmTrac is for you, too” Brochure - English (PDF)	08/2015	N/A	Available Online Only
11-13708A	“ImmTrac is for you, too” Brochure - Spanish (PDF)	04/2012	N/A	Maximum Limit: 500
11-13708P	“ImmTrac is for you, too” Poster-Young Adult - Bilingual (PDF)	12/2011	9″ × 12″ Poster	Maximum Limit: 25
11-13710	“Fight the Flu” Brochure - English (PDF)	08/2015	N/A	Available Online Only
11-13710A	“Fight the Flu” Brochure - Spanish (PDF)	08/2015	N/A	Maximum Limit: 500
11-13710P	“Fight The Flu” Poster - Bilingual (PDF)	12/2011	N/A	Maximum Limit: 25
11-13711	“Halt HPV” Brochure - English (PDF)	04/2012	N/A	Currently Not Available
11-13711A	“Halt HPV” Brochure - Spanish (PDF)	04/2012	N/A	Currently Not Available
11-13711P	“Halt HPV” Poster - Bilingual (PDF)	12/2011	N/A	Currently Not Available
11-13712	Meningitis Brochure - English (PDF)	04/2012	N/A	Currently Not Available
11-13712A	Meningitis Brochure - Spanish (PDF)	08/2012	N/A	Currently Not Available
11-14008	“Prevent Pertussis” Brochure - Bilingual (PDF)	01/2013	N/A	Maximum Limit: 500
11-14009P	“Now is the Time to Prevent Whooping Cough” Poster-Anglo Adults - English (PDF)	11/2012	N/A	Available Online Only
11-14009P-1	“Now is the Time to Prevent Whooping Cough” Poster-African Adults - English (PDF)	11/2012	18″ × 24″ Poster	Available online Only
11-14009P-2	“Now is the Time to Prevent Whooping Cough” Poster-Hispanic Adults - English (PDF)	11/2012	18″ × 24″ Poster	Available online only
11-14015P	“Flu Wants You” Poster - Bilingual (PDF)	09/2015	18″ × 25″ Poster	Maximum Limit: 50
11-14106	“First Responders - Get Vaccinated” Brochure - English (PDF)	10/2013	N/A	Maximum Limit: 500
11-14106P	gFirst Responders - Get Vaccinatedh Poster - English (PDF)	10/2013	18" x 24" Poster	Available Online Only
11-14120	“Hepatitis B: What Hospitals Need to Do to Protect Newborns” Booklet - English (PDF)	11/2013	N/A	Maximum Limit: 100
11-14121	Hepatitis B Birth Dose Honor Roll - English (PDF)	11/2013	N/A	Maximum Limit: 100
11-14122	Interpretation of Hepatitis B Serologic Test Results - English (PDF)	11/2013	N/A	Maximum Limit: 1000
11-14175	Pertussis Information Sheet - Bilingual (PDF)	03/2014	N/A	Available Online Only
11-14178	Pertussis TMP-SMZ (Bactrim, Septra, SMX/TMP) for Pertussis PEP Fact Sheet - Bilingual (PDF)	06/2015	N/A	Available Online Only
11-14179	Azithromycin for Pertussis PEP Fact Sheet - Bilingual (PDF)	08/2014	N/A	Available Online Only
11-14202	“Adults Need Vaccine Too” Adult Safety Net (ASN) Program Brochure - Bilingual (PDF)	01/2016	N/A	Maximum Limit: 500
11-14202P	“Adults Need Vaccine Too” Adult Safety Net (ASN) Program Poster - Bilingual	10/2015	N/A	Available Online Only
11-14429	Action Plan for the Prevention, Care, and Treatment of Viral Hepatitis Updated 2014–2016 - English (PDF)	05/2014	N/A	Available Online Only
11-14450P	Pre Teen Vaccine Poster - English (PDF)	08/2014	11″ × 17″ Poster	Available online only
11-14451P	HPV Poster - English (PDF)	08/2014	11″ × 17″ Poster	Available online only
11-14452P	Meningococcal Poster - English (PDF)	08/2014	11″ × 17″ Poster	Available online only
11-14453P	Tdap Poster - English (PDF)	08/2014	11″ × 17″ Poster	Available online only
11-14671	“Important ImmTrac Reminder!” ImmTrac Adult Consent Reminder Flyer - Bilingual (PDF)	12/2015	N/A	Available online only
11-14679	“Important Notice to the General Public” ImmTrac Reminder Notice - Bilingual (PDF)	09/2015	N/A	Available online only
11-14740	Perinatal Hepatitis B Prevention Program Prenatal / OBGYN Badge Buddy - English (PDF)	10/2016	N/A	Maximum Limit: 100
11-14741	Perinatal Hepatitis B Prevention Program Labor and Delivery / Newborn Nursery Hospital Badge Buddy - English (PDF)	10/2016	N/A	Available online only
11-14742	Perinatal Hepatitis B Prevention Program Pediatrician Badge Buddy - English (PDF)	10/2016	N/A	Maximum Limit: 100
59-12547	“Protect Babies from Hepatitis B for Life” Provider Brochure - Bilingual	07/2012	N/A	Currently Not Available
59-12818	Perinatal Hepatitis B Prevention Program Manual - English (PDF)	05/2016	N/A	Maximum Limit: 5
59-13390	“Protect Babies from Hepatitis B for Life” Perinatal Hepatitis B Prevention Program Provider Poster - Bilingual (PDF)	06/2016	11″ × 17″ Poster	Available online only
59-13391	gProtect Babies from Hepatitis B for Lifeh Perinatal Hepatitis B Prevention Program Parent/Patient Poster - Bilingual (PDF)	06/2016	17" X 11" Poster	Currently Not Available
C-7	ImmTrac Immunization Registry Consent Form - Bilingual (PDF)	05/2012	Birth Registrars DO NOT use this form.	Maximum Limit: 500
C-8	ImmTrac ”Withdrawal of Consent & Confirmation Form” - Bilingual (PDF)	02/2011	N/A	Available Online Only
C-9	Documenting History of Varicella (Chickenpox) Illness Form - Bilingual (PDF)	11/2016	N/A	Available Online Only
C-10	TVFC Patient Eligibility Screening Record - Bilingual (PDF)	08/2016	N/A	Available online only
C-11	School/Daycare Immunization Record - English (PDF)	04/2016	N/A	Available Online Only
C-33	Monthly Vaccine Report-Form - English	03/2016	Please contact your Health Service Region (HSR) representative to obtain a copy.	Currently Not Available
C-61	Adult Vaccination Reminder Card - Bilingual (PDF)	04/2009	N/A	Maximum Limit: 250
C-62	Adolescent Vaccination Reminder Card - Bilingual (PDF)	04/2009	N/A	Available Online Only
C-63	Clinic Delinquent Reminder Cards (Non-Postage) - Bilingual (PDF)	05/2008	N/A	Available online only
C-64	“Vaccines Build Your Child's Health” Reminder Postcard - Bilingual (PDF)	05/2008	N/A	Available Online Only
C-68-1	PEDIATRIC Biological Order Form (PDF)	06/2017	N/A	Available Online Only
C-68-2	ADULT Biological Order Form (PDF)	06/2017	N/A	Available Online Only
C-76	The Vaccine Adverse Event Reporting System (VAERS) form, stock number C-76 is no longer available from the Department of State Health Services Immunization Unit but is available from the Vaccine Adverse Event Reporting System (VAERS) website at https://vaers.hhs.gov/.		N/A	CNA
C-85	Pneumococcal Conjugate Vaccine Information Statement (VIS) - English Statement \| Addendum	11/2015	N/A	Maximum Limit: 500
C-85A	Pneumococcal Conjugate Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	11/2015	N/A	Maximum Limit: 500
C-86	Pneumococcal Polysaccharide Vaccine Information Statement (VIS) - English Statement \| Addendum	04/2015	N/A	Maximum Limit: 500
C-86A	Pneumococcal Polysaccharide Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	04/2015	N/A	Maximum Limit: 500
C-87	Live, Intranasal Influenza Vaccine Information Statement (VIS) - English Statement \| Addendum	08/2015	N/A	Available Online Only
C-87A	Live, Intranasal Influenza Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	08/2015	N/A	Available Online Only
C-90	Polio (IPV) Vaccine Information Statement (VIS) - English Statement \| Addendum	11/2011	N/A	Maximum Limit: 500
C-90A	Polio (IPV) Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	11/2011	N/A	Maximum Limit: 500
C-91	Diphtheria, Tetanus, and Pertussis (DTaP) Vaccine Information Statement (VIS) - English Statement \| Addendum	05/2007	N/A	Available online only
C-91A	Diphtheria, Tetanus, and Pertussis (DTaP) Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	05/2007	N/A	Maximum Limit: 500
C-92	Measles, Mumps, and Rubella (MMR) Vaccine Information Statement (VIS) - English Statement \| Addendum	04/2012	N/A	Maximum Limit: 500
C-92A	Measles, Mumps, and Rubella (MMR) Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	04/2012	N/A	Maximum Limit: 500
C-93	Influenza (Flu Vaccine, Inactivated or Recombinant) Vaccine Information Statement (VIS) - English Statement \| Addendum	08/2015	N/A	Available Online Only
C-93A	Influenza (Flu Vaccine, Inactivated or Recombinant) Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	08/2015	N/A	Available Online Only
C-94	Tetanus, Diphtheria (Td) Vaccine Information Statement (VIS) - English Statement \| Addendum	04/2017	N/A	Maximum Limit: 500
C-94A	Td Vaccine (Tetanus, Diphtheria)Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	04/2017	N/A	Maximum Limit: 500
C-95	Hepatitis A Vaccine Information Statement (VIS) - English	07/2016	N/A	Maximum Limit: 500
C-95A	Hepatitis A Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	07/2016	N/A	Maximum Limit: 500
C-96	Meningococcal Vaccine Information Statement (VIS) - English Statement \| Addendum	03/2016	N/A	Maximum Limit: 500
C-96A	Meningococcal Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	04/2017	N/A	Maximum Limit: 500
C-97	Chickenpox Vaccine Information Statement (VIS) - English Statement \| Addendum	03/2008	N/A	Maximum Limit: 500
C-97A	Chickenpox Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	03/2008	N/A	Maximum Limit: 500
C-99	Rabies Vaccine Information Statement (VIS) - English Statement \| Addendum	10/2009	N/A	Maximum Limit: 250
C-99A	Rabies Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	10/2009	N/A	Available online only
C-100	Vaccine Information Documentation - Bilingual (PDF)	04/2017	8 1/2" x 11"	Maximum Limit: 1000
C-102	Personal Immunization Record - Bilingual (PDF)	03/17	7" x 10"	Maximum Limit: 1000
C-103	My Child's Health Record - Bilingual (PDF)	08/2009	N/A	Available Online Only
C-104	Adult Immunization Record Card - Bilingual (PDF)	08/2013	N/A	Available online only
C-105	Temperature Recording Form - English (PDF)	01/2005	N/A	Available Online Only
C-106	Hepatitis B Vaccine Information Statement (VIS) - English Statement \| Addendum	07/2016	N/A	Maximum Limit: 500
C-106A	Hepatitis B Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	07/2016	N/A	Maximum Limit: 500
C-108	Haemophilus Influenzae (Hib) Type b Vaccine Information Statement (VIS) - English Statement \| Addendum	04/2015	N/A	Maximum Limit: 500
C-108A	Hib(Haemophilus Influenzae Type b) Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	04/2015	N/A	Maximum Limit: 500
C-109	Tetanus, Diphtheria, Pertussis (Tdap) Vaccine Information Statement (VIS) - English Statement \| Addendum	02/2015	N/A	Maximum Limit: 500
C-109A	Tetanus, Diphtheria, Pertussis (Tdap) Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	02/2015	N/A	Maximum Limit: 500
C-110	Rotavirus Vaccine Information Statement (VIS) - English Statement \| Addendum	04/2015	N/A	Maximum Limit: 500
C-110A	Rotavirus Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	04/2015	N/A	Available online only
C-112	Shingles Vaccine Information Statement (VIS) - English Statement \| Addendum	10/2009	N/A	Maximum Limit: 500
C-112A	Shingles Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	10/2009	N/A	Maximum Limit: 500
C-113	Your Baby's First Vaccines - Multi Vaccine, Vaccine Information Statement (VIS) - English Statement \| Addendum	11/2015	N/A	Available online only
C-113A	Your Baby's First Vaccines - Multi Vaccine, Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	11/2015	N/A	Maximum Limit: 500
C-115	Measles, Mumps, Rubella, and Varicella (MMRV) Vaccine Information Statement (VIS) - English Statement \| Addendum	05/2010	N/A	Maximum Limit: 500
C-115A	Measles, Mumps, Rubella, and Varicella (MMRV) Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	05/2010	N/A	Maximum Limit: 500
C-116	HPV (Human Papillomavirus) Vaccine: What You Need to Know - English Statement \| Addendum	12/02/2016	N/A	Maximum Limit: 1000
C-116A	HPV (Human Papillomavirus) Vaccine: What You Need to Know - Spanish Statement \| Addendum	12/2016	N/A	Available online only
C-117	Serogroup B Meningococcal (MenB) Vaccine Information Statement (VIS) - English Statement \| Addendum	08/2016	N/A	Maximum Limit: 1000
C-117A	Serogroup B meningococcal (MenB) Vaccine Information Statement (VIS) - Spanish Statement \| Addendum	08/2016	N/A	Maximum Limit: 1000
DV0499	“Keep children on track with ImmTrac” DVD - Bilingual	06/2009	N/A	Maximum Limit: 3
DV-0531	“First Responders: Keep Track with ImmTrac” DVD - English	08/2009	N/A	Maximum Limit: 3
E11-14564	Adult Safety Net (ASN) Program Provider Flyer - Bilingual (PDF)	06/2015	N/A	Available Online Only
F11-11443	Texas Vaccines for Children (TVFC) Provider Withdrawal Form - English (PDF)	11/2008	N/A	Available Online Only
EF11-14171	Texas Vaccines for Children (TVFC) Vaccine Borrowing Report Form - English (PDF)	03/2016	N/A	Available Online Only
F11-11539	Perinatal Hepatitis B Mom/Client Hospital Card - Bilingual (PDF)	06/2016	N/A	Maximum Limit: 50
F11-11936	ImmTrac Newborn Consent Form (ImmTrac NB-2) - Bilingual (PDF)	09/2012	N/A	Maximum Limit: 1000
F11-12842	Adult Safety Net (ASN) Eligibility Screening Form - Bilingual (PDF)	11/2013	N/A	Available Online Only
F11-12955	ImmTrac First Responder/Family Member Inclusion or Release Form - Bilingual (PDF)	09/2016	N/A	Available online only
F11-12956-P	ImmTrac Disaster Information Retention Consent Form - Bilingual (PDF)	09/2008	N/A	Maximum Limit: 500
F11-13078	First Responders ImmTrac Wallet Card - English (PDF)	11/2008	N/A	Available online only
F11-13366	ImmTrac Adult Consent Form - Bilingual (PDF)	09/2016	N/A	Available online only
F11-13678P	Immunization Clinic Poster - English (PDF)	08/2016	N/A	Maximum Limit: 25
F11-13788	Patient Referral Form for Vaccination - English (PDF)	12/2011	N/A	Available Online Only
F11-14174	Pertussis PEP Client Evaluation Form - English (PDF)	03/2014	N/A	Available Online Only
F11-14176	Pertussis PEP Medication Contraindications and Precautions Checklist - English (PDF)	06/2015	N/A	Available Online Only
F11-14177	Pertussis PEP Eligibility Criteria Checklist - English (PDF)	08/2014	N/A	Available Online Only
11-13338	Flu Fighters Activity Book - Bilingual (PDF)	10/2010	N/A	Available online only

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Important information regarding your Vaccine Information Statement (VIS) order! The CDC has authorized the Department of State Health Services to deplete existing VIS stock prior to distributing the most current version when only minor updates have been made.

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