Texas Asthma Camp Info
Camper Online Registration
General Info/What to Bring
Cost and
Financial Aid
Forms
Map to the Camp
2012 TAC Brochure

Call the camp at:
(903) 877-7075

© Texas Asthma Camp
& UTHSCT
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Register Online

Your online registration will be processed when your $15 registration fee has been received at the following address:

Texas Asthma Camp
Attn: UTHSCT Public Affairs
11937 U.S. Hwy. 271
Tyler, Texas 75708-3154

If you would like to receive a financial aid application, please mail your $15 registration fee to reserve a space for your child. A financial aid package will be mailed to you immediately. The registration fee is required regardless of financial aid status.

Contact/Camper Information
One Week Only
 June 10-15
Name of Camper:
Date of Birth:
Address:
City:
State:
Zip:
Day Phone:
Evening Phone:
Email:
Age While at Camp:
Sex:
 Male Female
Parent's/Guardian's Name:
Financial Aid Application
 Yes No
Asthma History
How many years has your child attended the Texas Asthma Camp for Kids?
How did you first hear about the Texas Asthma Camp?
How long has your child had asthma?
How many days of school has your child missed this year because of asthma?
How many times has your child been to the ER for asthma in the last 6 months?
Has your child been in the hospital in the last six months due to asthma?
 Yes No
Has your child used a nebulizer during the last six months?
 Yes No
List the asthma medications your child's doctor has prescribed.
List the asthma medications your child is able to take.
List any other medications your child is on.
Does your child have any other health or developmental problems? (i.e. ADHD, allergies)
 Yes No
If yes, list them.
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General Information
New Patient Appointments: (903) 877-7000
24-Hour Emergency Room: Hwy. 271 @ Hwy 155