Forms and Documents

ImmTrac2
FAQs
Client Benefits Register as an
Authorized Organization
Forms &
Documents
Meaningful
Use (HL7)
Contact
ImmTrac2

ImmTrac2 Forms & Documents

Print single copies below or order in quantity by stock number from www.ImmunizeTexasOrderForm.com. ImmTrac2 brochures and posters may also be ordered from the link above. For assistance with ordering, please call the Immunization Unit at (800) 252-9152. 
Stock # Title
General/Miscellaneous Consent Forms: 
C-7 Immunization Registry (ImmTrac2) - Minor Consent Form (rev. 03/2017) 
Use this form to register your child, aged 17 and younger, in ImmTrac2.
Birth registrars: DO NOT use this form. See F11-11936 below.
C-7A Registro de Inmunización (ImmTrac2) - Formulario de Consentimiento Para Menores (rev. 03/2017)
EF11-13366 Immunization Registry (ImmTrac2) - Adult Consent Form - (rev. 03/2017)
Use this form to register as an adult (aged 18 and older) in ImmTrac2.
EF11-1366ARegistro de Vacunas (ImmTrac2) - Formulario de Consentimiento Para Adultos (rev. 03/2017)
F11-12955   Immunization Registry (ImmTrac2) First Responder/First Responder Family Member Consent Form (rev. 03/2017)
Use this form to register as a first responder and first responder family members, aged 18 and older.
F11-12955ARegistro de Inmunización (ImmTrac2) - Formulario de Solicitud de Personal de Primera Respuesta / Un Familiar (rev. 03/2017)
F11-12956 Immunization Registry (ImmTrac2) Disaster Information Retention Consent Form (rev. 03/2017)
Use this form to retain your disaster-related information beyond 5 years.
F11-12956ARegistro de Inmunización (ImmTrac2) - Formulario de Consentimiento de Retención de Información Sobre el Desastre (rev. 03/2017)
Request an Immunization Record:
F11-11406 Immunization Registry (ImmTrac2) Authorization to Release Official Immunization History (rev. 03/2017)
Use this form to authorize the release of your or your child's ImmTrac2 records. 
Newborn Consent Form:
F11-11936 ImmTrac2 Newborn Registration Form - Bilingual (rev. 03/2017)
Use this form to grant or deny newborn registration in ImmTrac2.
For use by birth registrars only.
ImmTrac Withdrawal Form:
C-8 Immunization Registry (ImmTrac2) - Withdrawal of Consent and Confirmation Form (rev. 03/2017)
Use this form to withdraw your child or yourself from participation in ImmTrac2.
C-8A Registro de Inmunización (ImmTrac2) - Retiro de Consentimiento y Confirmación (rev. 03/2017)

Documents for Providers & Payors:
Stock #Title
11-11445                                   Electronic Transfer Standards for Providers - Coming Soon

Use this document only if you are a Provider. If you need information for payors, contact ImmTrac2 Customer Support at (800) 252-9152 or e-mail ImmTrac2@dshs.texas.gov

11-12158 Payor Information - Coming Soon
11-14955

ImmTrac2: Texas Immunization Registry User Manual (rev. 03/2017)

The ImmTrac2 User Manual provides information on the new system and  how to navigate through the system. 

11-14972

ImmTrac2 Implementation Guide for Immunization Messaging: HL7 Version 2.5.1 (rev. 01/2017)

The Implementation Guide provides specifications, standards, and examples for creating HL7 2.5.1 messages for data submissions for ImmTrac2. 

11-14977

ImmTrac2 Provider Online Enrollment Manual (rev. 02/2017)

The Provider Online Enrollment Manual provides information on the ImmTrac2 registration and renewal processes. 

11-12222   ImmTrac2 Consent Guidelines for Providers - Coming Soon
E11-11402 Frequently Asked Questions (FAQs) for Healthcare Providers - Coming Soon
E11-12934New User Welcome Kit - Coming Soon 
E11-14180 ImmTrac2 User Instructional Manual - Coming Soon
E11-14181 ImmTrac2 Consent Withdrawal Process for Providers Who Affirm Consent - Coming Soon
E11-14182 Meaningful Use (HL7) Quick Guide - Coming Soon

General Fact Sheets:
  • What is ImmTrac2? - Coming Soon
  • Impact of HIPAA on reporting to ImmTrac2 - Coming Soon
  • Current Texas Law: Immunization Reporting & Consent Requirements - Coming Soon

Helpful Links:


 

ImmTrac2: Pre Launch Webinars

 
Webinar Title:Date  of Webinar Recording:
  

ImmTrac2 - System Overview

Description: Introduction to the new system, including logging in, navigating and exploring all functional areas, resetting passwords, and understanding the user roles in the system.

Webinar Presentation Slides

March 9, 2017 - Webinar Recording

March 23, 2017 - Webinar Recording

  

ImmTrac2 - Clients

Description: Demonstration of how to view, add, and edit client information and manage client consent.

Webinar Presentation Slides

March 14, 2017 - Webinar Recording

March 28, 2017 - Webinar Recording

  

ImmTrac2- Immunizations

Description: Demonstration of how to view, add, edit, and delete immunizations, and how to print immunization records.

Webinar Presentation Slides

March 21, 2017 - Webinar Recording

March 30, 2017 - Webinar Recording




ImmTrac2: Post Launch Webinars

 
Webinar TitleDate of Webinar:
  

ImmTrac2 - System Overview 

Description: Introduction to the new system, including logging in, navigating and exploring all functional areas, resetting passwords, and understanding the user roles in the system.

May 2, 2017 - Webinar Recording

  

ImmTrac2 - Clients

Description: Demonstration of how to view, add, and edit client information and manage client consent.

May 16, 2017 - Webinar Recording

May 19, 2017 - Webinar Recording

  

ImmTrac2 - Immunizations

Description: Demonstration of how to view, add, edit, and delete immunizations, and how to print immunization records.

May 23, 2017 - Webinar Recording

May 25, 2017 - Webinar Recording




Instructional Videos

The following instructional videos will assist registered ImmTrac2 users in using the system.  The links will take viewers to the Texas Department of State Health Services YouTube Channel. 

Video Title Description 
  
Logging In and Password Reset The video covers logging in to ImmTrac2 and resetting your password.
  
Navigating ImmTrac2 The video covers navigating the menu bar and menu panel options, and introduces help features to learn more.  
  
Searching for Client Records The video covers the process for searching for client records. 
  
Viewing and Editing Client Records The video covers the process for viewing and editing client records.
  
Entering a New Client The video covers the process for adding new child and adult clients.  
  
Viewing and Editing Immunization Records The video covers the process for searching, viewing, and editing immunization records. 
  
Adding Immunizations The video covers the process for adding immunizations to a client record. 
  
Schools The video covers creating and editing school lists, assigning students (clients) to a list, and running school list reports.  
  
Generating Ad Hoc Reports The video covers the functions to generate user-defined reports for client and immunization information. 
  
Reminder/Recall Reports The video covers the Reminder/Recall Report selection options and report results, including formats for notices, letters, mailing labels, and client listings. 
  
Generating the Client Benchmark Report The video covers the Client Benchmark Report selection options and report results.  



Last updated May 31, 2017