Requisition For Texas Vital Statistics Forms printable pdf download

Requisition For Texas Vital Statistics Forms

REQUISITION FOR TEXAS VITAL STATISTICS FORMS

To assist Texas Vital Statistics in providing you with quality customer service when ordering

supplies, we would appreciate your completing and returning the “Requisition for Vital Statistics

Forms” (VS-100) to Texas Vital Statistics in the following preferred order:

FAX Supply Orders:

(512) 458-7506

1 .

Attn: VS Supply Representative

-OR-

2 .

Mail Supply Orders:

VS Supply Representative

Texas Vital Statistics

Texas Department of State Health Services

PO BOX 149347

Austin, TX 78714-9347

We recommend, if possible, that you FAX or MAIL your supply request.

On average, VS will mail your order within 3-5 days of receipt.

Please allow an additional 7-10 processing days through the U.S. Postal Service.

To check on the status of your supply order, you may call (512) 458-7111 ext 3392

Return Mailing Address:

________________________

_____________________________________

Organization Name

Mailing Address

________________________

_____________________________________

Attention:

City

State

Zip

________________________

____________________

Telephone # (M-F, 8am – 5pm)

Date of Request

Name of Form

Form No.

Quantity

Forms Provided by Texas Vital Statistics are on the Back.

VS-100 Rev. 04/2016

Texas Department of State Health Services - Texas Vital Statistics

Requisition For Texas Vital Statistics Forms