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Get Tx C-107e 2006-2025

DATE OF BIRTH: AGE: This Form has been adopted by the Texas Medical Board in accordance with the requirements of 164.052(c), Texas Occupations Code and is published in 22 Texas Administrative Code 165.6(f). The purpose of this Form is to allow the physician to obtain the required consents for an abortion to be performed on an unemancipated minor. This Form is available for downloading on the Texas Medical Board web site at www.tmb.state.tx.us.

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