Forms and Documents

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Find the Document You're Looking for:

Forms for the General Public

• Consent Forms for the Public – Minors and Adults
  
• Immunization Record Request
• Withdrawal Form

Providers and Organizations

• Newborn Registration Form
  
• Manuals for Providers and Organizations

Disaster Information Retention Consent Forms

• Consent Form for First Responders and Family Members
• Disaster Information Retention Form

Print or order in quantity. For assistance, call the Immunization Unit at (800) 252-9152. 

ImmTrac2 Forms & Documents

Stock #	Title
Consent Forms for Minors and Adults:
C-7	Immunization Registry (ImmTrac2) - Minor Consent Form (Bilingual) (rev. 02/2022)  Use this form to register your child, aged 17 and younger, in ImmTrac2. Birth registrars: DO NOT use this form. See F11-11936 below.
F11-13366	Immunization Registry (ImmTrac2) - Adult Consent Form (Bilingual) (rev. 02/2022) Use this form to register as an adult (aged 18 and older) in ImmTrac2.
Request an Immunization Record:
F11-11406	Immunization Registry (ImmTrac2) Authorization to Release Official Immunization History (Bilingual) (rev. 02/2022) Use this form to authorize the release of your or your child's ImmTrac2 records.
ImmTrac2 Withdrawal Forms:
C-8	Immunization Registry (ImmTrac2) - Withdrawal of Consent and Confirmation Form (Bilingual) (rev. 02/2022) Use this form to withdraw your child or yourself from participation in ImmTrac2.

Stock #	Title
Newborn Consent Form:
F11-11936	ImmTrac2 Newborn Registration Form (Bilingual) (rev. 02/2022) Use this form to grant or deny newborn registration in ImmTrac2. For use by birth registrars only.
Data Exchange Resources:
11-16666	Bidirectional Data Exchange Onboarding Guide (rev. 08/2022)
11-16669	ImmTrac2-Data Exchange Guide: How to Resolve Errors IEE-201 & IEE200 (rev. 06/2022)
11-16626	COVID-19 Data Exchange Reporting FAQ (rev. 02/2022)
11-15231	Electronic Data Exchange Resource Guide (rev. 12/2019)
11-14972	Texas Immunization Registry HL7 2.5.1 Implementation Guide (rev. 04/2021)
11-15235	Bidirectional Readiness Checklist  (rev. 02/2021)
11-15236	Secure File Transfer Protocol Specifications (rev. 01/2021)
11-15702	Texas Immunization Registry - Consent Overview (rev. 03/2020)
11-15703	Texas Immunization Registry HL7 2.5.1 Error Guide (rev. 06/2020)
11-15773	Affirmation of Registry Consent via Health Level Seven (rev. 04/2022)
E11-13415	Electronic Standards for Affirmation of Registry Consent (rev. 06/2020)
11-15957	Informational Guide on Bidirectional Data Exchange (rev. 01/2021)
Manuals and Guides:
11-16668	ImmTrac2 Quick Guide - How to Resolve Questionable Matches (rev. 06/2022)
11-16681	ImmTrac2 Ad Hoc Count Report Guide (rev. 08/2022)
11-16619	Single Sign-On Quick Guide (rev. 02/2022)
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.
11-15175	ImmTrac2 Site Registration Guide (rev. 11/2021)
11-15226	ImmTrac2 Guide to the Ad Hoc List Report (rev. 02/2021)
11-15232	Data Quality Guide - Common Issues of Inaccurate Report Data (rev. 10/2019)
11-15252	ImmTrac2 Site Renewal Guide (rev. 07/2020)
11-15026	ImmTrac2 Quick Guide - Change Password (rev. 10/2020)
11-15714	Quick Guide_How to Merge Clinicians in ImmTrac2 (rev. 04/2020)
11-15951	ImmTrac2 Manage Client Status Criteria (rev. 10/2020)
11-15952	Texas DSHS Immunization Portal Registration Guide (rev. 1/2021)
Educational Materials:
11-15326	ImmTrac2 Reminder for Providers
11-15325	Benefits of Participating in ImmTrac2
11-15324	Provider Benefits of Using ImmTrac2

Stock #	Title
F11-12956	Immunization Registry (ImmTrac2) Disaster Information Retention Consent Form  (Bilingual) (rev. 02/2022) Use this form to retain your disaster-related information beyond 5 years.
11-15954	ImmTrac2 Disaster Consent Overview (rev. 12/2020)