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Home >
Texas Vital Statistics >
Request Certificates >
Health, Social, Education and Genetic History Report Forms
Health, Social, Education and Genetic
History Report Forms
Per Texas Family Code §161.1031 Medical History Report, and §162.005 – §162.008 HSEGH
reporting: http://www.statutes.legis.state.tx.us/
On all non-relative private adoptions when no adoption agency is involved, attorneys shall
submit to vital statistics (VSU) a HSEGH report and its addendum prior to consummation. This
report is certified by VSU and the certification of receipt is sent to the attorney as evidence that
the report has been filed. This report may be waived by the court.
1. HSEGH – a form that is completed by the attorney: HSEGH Form (DOC 40K)
2. Addendum to HSEGH – a form to be completed by the birth parents: Download
Addendum Form (DOC 192K)
3. Information Cover Sheet – Information about the adoption to be completed by the
attorney and submitted to VSU as a cover sheet with the HSEGH documents:
Download Information Form (DOC 108K)
After the birth parents have filled out the reports and submitted them back to the attorney, the
attorney will mail them to the following address along with documentation that allows VSU to
index the report. No fee is required.
VSU—CAR
DSHS MC 1966
P.O. Box 149347
Austin, TX 78714-9347
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Last updated January 08, 2016
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