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Documentation of Information Texas Law Requires Pregnant Women Receive Publications on the DSHS Website

[Click HERE to print this page, sign and return.]

In compliance with Texas Health and Safety Code, Chapter 81, Section 81.090,"Serological Testing During Pregnancy," effective January 1, 2010, I have read and understand the following from the DSHS website:

__  If You Are Pregnant or Think You May Be Pregnant, You Need To Know about HIV

__  Pregnant? Protect Your Baby From Syphilis

__  Pregnant? Protect Your Baby From Hepatitis B

__  Pregnant? Protect Your Baby From Rubella

In compliance with Texas law (SB 316), effective September 1, 2005, I have read and understand the following from the DSHS website:

__  Information for Parents of Newborn Children

__  Mental Health, How to Get Help

In compliance with Texas law (HB 709), effective 2007, I have read and understand the following from the DSHS website: 

__  Information on Umbilical Cord Blood Banking and Donation

In compliance with Texas law (HB 1240), effective September 1, 2009, I have read and understand the following from the DSHS website:

__  A Parent's Guide to Raising Healthy, Happy Children

__  Guidelines for Vaccinating Pregnant Women, including Tetanus, Diphtheria, and Pertussis (Tdap); & Tetanus and Diphtheria (Td)

 I have read and understand all the documents above.

________________________________________Mother's Name (Please Print Clearly)

________________________________________Mother's Signature    ____________Date