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Texoma Physicians Group PLLC fax number

(903) 202-2901

Immunization Registry (ImmTrac2) forms submission

Used for: Submission of immunization-related forms and patient information to ImmTrac2; transmitting immunization records and consent documents.

Fax destination details

Department
Immunization Registry (ImmTrac2) forms submission
Purpose
Submission of immunization-related forms and patient information to ImmTrac2; transmitting immunization records and consent documents.
Form
ImmTrac2 Minor Consent form — ImmTrac2 Minor Consent form
Address
220 E Evergreen St, Sherman, TX 75090
Voice phone
903-202-2900

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Instructions for completing minor consent and consent for immunization registry participation; includes parental authorization for treatment of a minor.

Official form instructions are published as a downloadable file on the organization's website.

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