TX DSHS EC-105RC 2016-2025 free printable template
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Temperature Recording Form for Refrigerator
CelsiusMonth / Learnability Gametic Coordinator
Take action if temp is out of range too warm (above 8C) or too cold (below 2C). Monitor temperatures closely!1.
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How to fill out TX DSHS EC-105RC
01
Obtain a blank TX DSHS EC-105RC form from the Texas Department of State Health Services website or local office.
02
Fill in the applicant's name, address, phone number, and email at the top of the form.
03
Provide the requested information about the child, including their name, date of birth, and school district.
04
Indicate the reason for the request by selecting the appropriate checkbox or writing a brief explanation.
05
Complete any additional sections as required by the form, including details about previous immunizations or health screenings.
06
Review the form for completeness and accuracy before submission.
07
Sign and date the form at the bottom to certify that the information provided is true and correct.
08
Submit the completed form to the appropriate department or agency as instructed.
Who needs TX DSHS EC-105RC?
01
Parents or guardians of children who require a Certificate of Existence for their child.
02
Child care centers or schools requiring proof of immunizations or health screenings.
03
Health care providers who need to verify a child's immunization status.
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What is TX DSHS EC-105RC?
TX DSHS EC-105RC is a Texas Department of State Health Services form used for reporting the immunization status of children.
Who is required to file TX DSHS EC-105RC?
Childcare facilities and schools in Texas are required to file TX DSHS EC-105RC to report immunization records.
How to fill out TX DSHS EC-105RC?
To fill out TX DSHS EC-105RC, provide the child's information, vaccination dates, and the signature of the healthcare provider.
What is the purpose of TX DSHS EC-105RC?
The purpose of TX DSHS EC-105RC is to ensure that children in Texas are vaccinated according to state immunization requirements.
What information must be reported on TX DSHS EC-105RC?
The information that must be reported includes the child's name, date of birth, vaccination dates, and any exemptions.
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