Appointment
Immunization Signature Sheet

Adult consent is required for immunizations. If your child is under 18 years of age and will be coming to an appointment by themselves, please print, sign and fax the Immunization Signature Sheet to 972-733-6564 prior to their appointment.

Patient Info

©2019 Girls to Women/Young Men's Health & Wellness
P: Dallas: 972-733-6565
P: Fort Worth: 817-524-1811 P: McKinney: 972-502-9099

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