Salvation Army – Alief

This clinic is for children who are between the ages of 2 months and 18 years old.  The child must be uninsured, medically under-insured, on Medicaid American Indian or Alaskan Native children are also eligible.

Please bring the following items with you:
1. Your child’s immunization record.
2. Intake forms. You can download the patient forms found below.
3. Everyone who enters the clinic will be required to follow social distancing guidelines and wear a mask. Face masks are required during this clinic.

Please note that we are doing all we can to protect the families and our medical professionals during this COVID pandemic.  Due to this, we must limit the number of people inside the clinic. ONLY ONE ADULT AND THE CHILD(REN) RECEIVING THE IMMUNIZATIONS WILL BE ALLOWED INTO THE CLINIC.

Please make sure you have childcare for your other children and do not bring them with you. We apologize for any inconvenience this may cause you.

Patient Intake Forms

Dallas Espanol Patient Packet

2020 General Intake Form English-DFW