Become an ASN Provider - Adult Safety Net Program

About the Program

Currently, there are significant numbers of adults in Texas who are not immunized for recommended vaccinations, meaning that they are at an increased risk of developing vaccine-preventable diseases. Your participation in the ASN Program would help to address this important public health issue by providing access to vaccines for uninsured adults. Also, since ASN Program vaccines are of no cost to your facility, and you may charge an administration fee of up to $25 per vaccine, joining the ASN Program is both beneficial to your business, as well as to the health of Texans.

Provider Eligibility

Provider types that may enroll in the ASN Program include, but may not be limited to, clinics that are formally recognized as one of the following:

  • DSHS Health Service Region (HSR) Offices;
  • Local Health Department (LHD);
  • Federally Qualified Health Centers (FQHC); and
  • Rural Health Clinics (RHC)


    New Providers

    If you are not currently enrolled in the Texas Vaccines for Children (TVFC) Program, please contact the Adult and Adolescent Immunization coordinator for your health service region.

    Texas Vaccines for Children Providers

    If you are currently enrolled in the Texas Vaccines for Children (TVFC) Program and are interested in becoming an Adult Safety Net Program provider, please contact your local TVFC representative for assistance to complete the Adult Safety Net Provider Enrollment Form (Publication F11-14143). The TVFC representative will submit the form on your behalf and will contact you once it's processed regarding next steps.

    Vaccines Offered

    The current DSHS Adult Safety Net vaccine formulary includes the following vaccines:

    • Hepatitis A vaccine
    • Hepatitis B vaccine
    • Combination hepatitis A-hepatitis B vaccine
    • Human papillomavirus (HPV) vaccine
    • Measles, mumps, & rubella (MMR) vaccine
    • Meningococcal vaccine
    • Pneumococcal polysaccharide vaccine (PPSV23)
    • Pneumococcal conjugate vaccine (PCV13)
    • Tetanus, diphtheria, & pertussis (Tdap) vaccine
    • Tetanus-diphtheria (Td) vaccine
    • Varicella vaccine
    • Zoster vaccine

    Additional Questions

    For further questions, please contact the Adult Safety Net Program Coordinator at

    Last updated November 8, 2017