Gastroenterology, Hepatology and Nutrition (RESEARCH) Academic General Pediatrics Academic General Pediatrics Second Opinion Clinic Acute Outpatient Rehabilitation Program Adolescent Medicine Adult Congenital Heart Program Aerodigestive Program Allergy and Immunology Ambulatory Nutrition Services Anesthesiology, Perioperative & Pain Medicine Angelman Syndrome Clinic Anomalous Aortic Origin of a Coronary Artery (AAOCA) Aquatic Therapy Asthma Center Audiology Bariatric Surgery Program Biliary Atresia Clinic Bleeding Disorders Bone Marrow Failure Program Bone Marrow Transplant / Stem Cell Transplant Program Bone Tumor Program Brachial Plexus Clinic Brain Tumor Program Breast Clinic Cancer and Hematology Center Cancer Genetics Clinic Cancer Prevention and Screening Clinic Cancer Survivor Program Cardiac Developmental Outcomes Program Cardiac Imaging Program Cardiac Intensive Care Unit (CICU) Cardiac Nursing Cardiology Cardiology Transition Medicine Program Cardiovascular (CV) Anesthesia Cardiovascular Genetics Program Cardiovascular Oncology Celiac Disease Clinic Center for Child Health Policy and Advocacy Cerebral Palsy Clinic Child Abuse Pediatrics (CAP) Child Life Department Cleft Lip and Palate Clinic Clinical Research Center Clubfoot Program Cochlear Implant Program Colorectal & Pelvic Health Program Complex Care Clinic Complex Urological Reconstruction Program Computed Tomography (CT) Congenital Heart Surgery Craniofacial Clinic Services for International Patients Critical Care Cystic Fibrosis Care Center Death of a Child Dental Dermatology Desmond Neonatal Follow-Up Clinic Developmental Pediatrics and Autism Developmental Therapeutics Phase I Clinic Diabetes and Endocrinology Diagnostic Odyssey Program The Disney Children’s Hospitals Program Down Syndrome Clinic ECMO (Extracorporeal Membrane Oxygenation) EOS Ear & Hearing Center Ear, Nose and Throat (Otolaryngology) Electrodiagnosis (EMG/Nerve Conduction Studies) Clinic Electrophysiology Program Emergency Center Endocrinology Eosinophilic Gastrointestinal Disorders Clinic Epilepsy Center Ewing Sarcoma Center Ethics Facial Reanimation Clinic Fertility Fetal Cardiology Program Fetal Center First Seizure Clinic Food Allergy Program Food and Nutrition Fracture Program Fragile X Clinic GROW Clinic Gastroenterology, Hepatology and Nutrition Gastrointestinal Procedures Suite (GIPS) Genetic Disorders of Obesity Program Gender Medicine Program General Hematology Program General Surgical Oncology Genetic Aortic Disorders Clinic Genetics Global Health Global Hematology Oncology Pediatric Excellence (HOPE) Gynecologic Oncology Hand and Upper Extremity Program Head and Neck Tumor Program Headache Clinic Heart Center Tissue Bank Heart Center Heart Failure Program Heart Transplant Hematology Center Hematology Hemostasis and Thrombosis Program Hip Preservation Program Histiocytosis Program Houston Texans Partnership ILD and Rare Lung Diseases Immune Hematology Program Immunization Project Immunotherapy Program Infectious Disease Inflammatory Bowel Disease (IBD) Program Infusion Center Injury Prevention Inpatient Rehabilitation Unit (IRU) International Adoption International and Destination Medicine Interventional Cardiology Program Interventional Radiology Intestinal Rehabilitation Clinic Intrathecal Baclofen Therapy (Intrathecal Baclofen Pump) Iron Disorders and Nutritional Anemias Program Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital Kamp K'aana Kangaroo Crew® Kidney (Renal) Kidney Stone Clinic Kidney Transplant Labor & Delivery Leukemia Program LifeIMAGE Limb Deformity & Reconstruction Liver Center Liver Intensive Care Unit Liver Transplant Liver Tumor Program Lung Transplant Lupus Clinic Lymphoma Program Magnetoencephalography (MEG) Maternal Fetal Medicine Metabolic Genetics Clinic Microbiome Center Microtia and Atresia Program Milk Bank (Lab) Services Mobile Clinics Mobile Clinic Event Request Form Our Team Services Fleet Information Other Information Motion Analysis Lab Movement Disorders Program MRI (Magnetic Resonance Imaging) Multiple Sclerosis Clinic Muscular Dystrophy Association (MDA) Clinic Neonatal Intensive Care Unit Nephrology Neuroblastoma Program Neurocritical Care Neurofibromatosis Clinic Neurogastroenterology and Motility Program Neurogenetics Clinic Neurology Neurophysiology Neuroscience Center Neurosurgery Neurosurgical Oncology Nuclear Radiology Nursing Obesity and Weight Management Obstetrics and Gynecology Ocular Oncology Oncologic Transplantation Oncology Ophthalmology Orthodontics Orthopedic Oncology Orthopedics PASS Clinic Pain Medicine Palliative Care Palliative Care Program (Cancer and Hematology) Pancreaticobiliary Program Pathology Pathology Outreach Pectus Program Pediatric and Adolescent Gynecology Pediatric Hospital Medicine Pediatric Neuropsychology Pediatric Psychology Pediatric Stroke Clinic Pediatric Surgery Periwinkle Arts in Medicine Program PET/CT Physical Medicine and Rehabilitation Physical and Occupational Therapy Plastic & Reconstructive Oncologic Surgery Plastic Surgery Polyposis Program Prader-Willi Clinic Precision Oncology Consultation Service Prenatal & Reproductive Genetics Preventive Cardiology Program Primary Care Practice at Palm Center Program for Immigrant and Refugee Child Health Psychiatry Psychology Public Health Pediatrics Pulmonary Diagnostic Lab Pulmonary Hypertension Pulmonary Medicine Pulmonary Vein Stenosis Program Radiography (X-Ray) and Fluoroscopy Radiology Sedation Radiology Rare Tumors Program Reproductive Health Reproductive Psychiatry Retinoblastoma Program Retrovirology (HIV) Rett Center Rheumatology Right Ventricular (RV) Failure Program Robotic Surgery Program Safety & Outcomes Keeping Our Patients Safe Providing Service Based on Respect Ensuring Prompt Access to Care Coordinating Your Child's Care Supporting Health and Wellness Outcomes by Service Clinical Standards Schroth Therapy Scoliosis & Spinal Deformity Sickle Cell and Thalassemia Program Simulation Center Single Ventricle Program Single Visit Surgery Skeletal Dysplasia Program Skull Base Program Sleep Center SOAR Program Social Work Soft Tissue Sarcoma Program Solid Tumor Programs Spasticity Management Specialty Pharmacy Speech, Language and Learning Spina Bifida Program Spiritual Care Sports Concussion Program Sports Medicine Sports Nutrition Sports Physical Therapy Surgery Surgical Oncology Program Teen WOW Texas Children's Hospital The Woodlands Texas Children's Hospital West Campus Texas Children's Pediatrics Texas Children's Urgent Care Texas Children’s Fetal Center™ Thyroid Cancer Program Thyroid Program Tracheostomy Program Transition Medicine Transplant Services Trauma Traumatic Brain Injury (TBI) Clinic Travel Medicine TrialNet U.S. News & World Report Ultrasound upWORDS:Baby and upWORDS:Toddler Urologic Oncology Urology Vaccine Awareness and Research (CVAR) Vaccine Development (Center for Vaccine Development) Vannie Cook Children's Clinic Vascular Anomalies Center Viral Hepatitis Program Voiding Improvement Clinic Volunteer Services Wheelchair Clinic William T. Shearer Center for Human Immunobiology Wound Care Young Women's Bleeding Disorder Clinic Home Departments and Services Mobile Clinics Mobile Clinic Event Request Form Event Date * *Please give 30 days advance notice. Event Time * Organization/Business Name * Location of Event * Address * Address Address 2 City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Zipcode Phone * Contact Names Contact Phone * Contact Fax Contact Fax Contact Fax Contact Email How many VFC eligible children do you expect will come for immunizations? * * We are Texas Vaccines for Children providers. For questions on eligibility, please call 832-824-6788. CRITERIA: Monday - Thursday: Must have 30 children needing immunizations. Friday - Must have 50 children attending. Saturday - Must have 100+ children needing immunizations. Do you have the space for a 40-foot long, 14-foot high mobile clinic? * No Yes Must be clear of low hanging wires and trees, steep inclines, and fire lanes/zones. Are you able to provide a registration area in a climate-controlled area with one table and two chairs indoors and access to an electrical outlet for the mobile clinic staff? * No Yes Have you had an immunization event before? If yes, how many children were immunized? What other services will you offer at the event? Can you provide a waiting area indoors for families waiting to be immunized? * No Yes Will other immunization providers or mobile clinics be attending this event? * No Yes How will you promote the event? In the event of mobile clinic technical failure, would you be able to provide a room indoors to immunize children to avoid cancellation? * No Yes PLEASE NOTE: We carefully consider all requests submitted throughout the year. Requests for the months of July and August will be reviewed after March 15th. Please keep in mind that early submissions do not always guarantee acceptance. How will you promote the event? (mark all that apply) * Fliers Radio/TV Door-to-door Letter to parents Other