The Texas Tdap consent form is the document a parent, legal guardian, or managing conservator signs to authorize a healthcare provider to give a child the tetanus, diphtheria, and pertussis booster that Texas requires for seventh-grade enrollment.1Texas Department of State Health Services. 2026 Texas Minimum State Vaccine Requirements for Students The provider supplies the form at check-in. You fill in the child’s identifying information, answer medical screening questions honestly, confirm you received the federal Vaccine Information Statement, and sign and date it the day of the appointment.
Who Can Legally Sign
Only a parent, legal guardian, or managing conservator may sign a vaccine consent form for a child under 18. Texas Family Code Section 32.001 specifically excludes immunizations from the list of medical treatments that grandparents, adult siblings, or other relatives can authorize when a parent is unreachable.2State of Texas. Texas Family Code Section 32.001 – Consent by Non-Parent Stepparents, foster parents, and other caretakers without legal guardianship or managing conservatorship cannot sign, regardless of their day-to-day role in the child’s life. Sort this out before the appointment. Arriving at the clinic with the wrong adult is one of the most common reasons families leave without the shot.
Where the Form Comes From
You probably don’t need to hunt one down. The pediatrician’s office, pharmacy, or local health department clinic that administers the vaccine hands you their consent paperwork at check-in. The Texas Department of State Health Services publishes official immunization forms online, and many providers use the DSHS templates or their own versions that collect the same information.3Texas DSHS. Forms If the provider also offers enrollment in ImmTrac2, the state immunization registry, that consent is a separate form in the same packet.
Filling Out the Form
Every version of the form covers three things: who the patient is, whether the vaccine is safe for them, and your informed, dated signature. Providers need all three complete before they can give the injection.
Patient Information
Enter the child’s full legal name, date of birth, gender, and current home address. These fields must match the child’s school enrollment records, since the completed form eventually goes to the school nurse. Most forms also ask for a phone number, email address, and the mother’s first and maiden name. That last detail helps link the record to birth certificate data in the state system.
Medical Screening Questions
Before the shot, the provider needs to know whether anything in the child’s medical history makes Tdap risky. The CDC lists several conditions to flag for the clinician before proceeding:4Centers for Disease Control and Prevention. Tdap (Tetanus, Diphtheria, Pertussis) Vaccine VIS
- A prior severe allergic reaction to a tetanus, diphtheria, or pertussis vaccine, or any severe, life-threatening allergy.
- A coma, reduced consciousness, or prolonged seizures within seven days of a previous pertussis-containing vaccine.
- An ongoing seizure disorder or other nervous system problem (not a one-time childhood febrile seizure).
- A prior diagnosis of Guillain-Barré Syndrome at any point.
- Significant pain or swelling after any previous tetanus or diphtheria shot.
Children who are moderately or severely ill on the day of the appointment should wait until they recover. Answer every screening question honestly. If the provider decides Tdap is medically contraindicated, the child may qualify for an exemption instead.
Vaccine Information Statement and Signature
Federal law requires every healthcare provider to give you a copy of the Vaccine Information Statement for Tdap before administering the dose.5Office of the Law Revision Counsel. 42 USC Chapter 6A Subchapter XIX Part 2 Subpart C – Assuring a Safer Childhood Vaccination Program The VIS is a standardized two-page CDC document explaining the vaccine’s benefits, risks, and what to do if a serious reaction occurs. Read it. It takes about two minutes. Then sign and date the consent form. The date matters: providers can refuse to vaccinate if the signature date doesn’t match the appointment date, since the form confirms same-day informed consent.
ImmTrac2 Is a Separate Consent
Texas operates ImmTrac2, a statewide immunization registry that stores vaccination records electronically.6State of Texas. Texas Health and Safety Code Section 161.007 – Immunization Registry, Reports to Department The ImmTrac2 consent form usually sits in the same paperwork packet, but it controls whether the state can store and share your child’s immunization data, not whether the vaccine can be given. Signing the vaccination consent form does not enroll your child in the registry.
If you grant ImmTrac2 consent, the child’s records follow them across providers and school districts within Texas, which saves you from digging up paper records years later. If you decline, the provider keeps a local record but uploads nothing to the state system. The ImmTrac2 minor consent form asks for the child’s name, address, date of birth, gender, mother’s name and maiden name, race, ethnicity, and whether the child is an immediate family member of a first responder.7Texas Children’s Hospital. Texas Immunization Registry (ImmTrac2) Minor Consent Form
One wrinkle worth knowing now: parental ImmTrac2 consent does not last forever. When the child turns 18, providers lose access to the records. The individual must sign an adult consent form before turning 26 to keep their childhood immunization history in the registry. If they never sign, all childhood records are purged.8Texas Department of State Health Services. Overview of ImmTrac2 Remind your child when they turn 18.
Getting Proof to the School
After the vaccine is given, the provider stamps or signs an immunization record showing the Tdap dose, the date administered, and the provider’s information. Deliver that validated record to the school nurse or registrar’s office to satisfy the seventh-grade enrollment requirement.9Texas Department of State Health Services. Requirements If you enrolled in ImmTrac2, the school may be able to pull the record electronically, but bring the paper copy anyway.
Keep your own copy. Providers can furnish duplicates later, but it takes time and the office may charge a records fee. Having a copy on hand prevents delays for school sports physicals, summer camp enrollment, and college applications that ask for proof of the Tdap booster.
Students who have not received the booster can be provisionally enrolled while they begin the immunization process. Confirm the timeline with the school district, since the state authorizes provisional admission but individual districts may set their own deadlines for completion. A Td (tetanus-diphtheria only) vaccine is accepted in place of Tdap when a medical contraindication to the pertussis component exists.
If You Need an Exemption Instead
Texas allows two types of exemptions from school immunization requirements: medical and conscientious (which includes religious belief).
Medical Exemption
A licensed physician who has examined the child can sign a certificate stating that the Tdap vaccine poses a significant health risk to the child or a member of the child’s household.10Justia Law. Texas Education Code Chapter 38 – Health and Safety Submit the signed physician’s certificate directly to the school.
Conscientious Exemption
A parent, guardian, or managing conservator may decline the vaccine for reasons of conscience, but the process requires a specific DSHS affidavit form. You cannot write your own letter or use a generic form. The affidavit must be notarized and submitted to the school within 90 days of notarization.11State of Texas. Texas Health and Safety Code Section 161.0041 – Immunization Exemption Affidavit Form
You can download the affidavit from the DSHS website (available since September 1, 2025), request it by mail, fax, or online submission, or pick it up in person at the DSHS office in Austin. Mailed, faxed, and online requests take approximately three weeks to arrive by mail. In-person requests can be picked up the same day.12Texas Department of State Health Services. Texas Immunization Exemptions A child may be provisionally enrolled for 30 days while waiting for the exemption form to arrive. Do not modify the affidavit in any way before submitting it to the school.
What the Booster Costs
Most private insurance plans cover the Tdap booster with no out-of-pocket cost under the Affordable Care Act’s preventive care mandate. For uninsured or underinsured children, the Texas Vaccines for Children (TVFC) program provides vaccines at no charge through enrolled providers, including pediatricians, local health departments, and DSHS regional offices. Eligible children include those on Medicaid, uninsured children, underinsured children whose plans don’t cover vaccines, American Indian or Alaska Native children, and CHIP enrollees (at CHIP-billing providers).13Texas Department of State Health Services. Texas Vaccines for Children TVFC providers may charge an administration fee of up to $13.75 per dose, but they cannot turn a child away for inability to pay it. Children are eligible for the TVFC program until they turn 19.