WitrynaTexas Department of State Health Services • ImmTrac Group • MC 1946 • P. O. Box 149347 • Austin, TX 78714-9347 PROVIDERS REGISTERED WITH ImmTrac2: Please enter client information in ImmTrac2 and affirm that consent has been granted. DO NOT fax to ImmTrac2. Retain this form in your client’s record. Stock No. F11-13366 … WitrynaThe Texas Immunization Registry. Whether you’re a health care provider or school nurse or administrator, ImmTrac2 makes a seemingly impossible task easy. At your …
REGISTRO DE INMUNIZACIÓN (ImmTrac2) FORMULARIO ... - Corpus Christi, Texas
WitrynaTexas Department of State Health Services Immunizations Stock No. F11-13366 Revised 2/222 Texas Immunization Registry (ImmTrac2) Adult Consent Form Address Apartment # / Building # City State Zip Code County Mother’s First Name Mother’s Maiden Name First Name Middle Name Last Name Gender: Female Male Date of … WitrynaMoved Permanently. The document has moved here. flip flops michael kors
About ImmTrac2 Texas DSHS
WitrynaADULT CONSENT FORM (Please print clearly) First Name Middle Name Last Name Address Apartment # / Building # ... (512) 776-7284 • Fax: (866) 624-0180 • www.ImmTrac.com Texas Department of State Health Services • ImmTrac2 Group – MC 1946 • P. O. Box 149347 • Austin, TX 78714-9347 PROVIDERS REGISTERED WITH … WitrynaUpon completion, please fax or mail form to the DSHS ImmTrac Group or a registered Health-care provider. Questions? (800) 252-9152 • (512) 776-7284 • Fax: (866) 624-0180 • www.ImmTrac.com ImmTrac FR/FM Stock No. EF11-12955 ... ImmTrac, the Texas immunization registry, is a free service of the Texas Department of State Health … Witryna27 lut 2024 · According to Texas Law, the following persons/entities may legally access your personal information stored in the ImmTrac system: – Texas public health district or local health department (to use the data for “internal public health research”) ... We checked the deny box on the immtrac form to opt out…however a few weeks later … greatest and least integer function