For Clients

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:

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

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

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

 I have read and understand all the documents above.

________________________________________Mother's Name (Please Print Clearly)

________________________________________Mother's Signature    ____________Date