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Documents, Instructions and Manuals
Instructions
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Online Access Forms
Data Exchange Interface (DEI) Forms
HL7 Vaccine Codes
Paper Reporting
User Confidentiality Statement for Online Access and Acceptable Use Protocol
UPIF Provider's Guide
Web File Repository Guide
Online Access to the CIR
view (168 KB, 2 pages)
To access the Online Registry (OR) through the website, each health care facility or practice designates a Security Administrator (User Manager). The OR Acceptable Use Protocol and Security Administrator (User Manager) Confidentiality Statement must be read and signed by the designated Security Administrator and returned by mail or fax to the CIR along with the Security Administrator (User Manager) User ID/Password Request Form (Private) (PDF file, 232 KB, 1 page) or Security Administrator (User Manager) User ID/Password Request Form (Facilities) (PDF file, 160 KB, 1 page) to obtain online access/reporting privileges.
Data Exchange Interface (DEI) Forms
view (210 KB, 13 pages)
Instructions, specifications, forms and other related DEI documents needed for the Data Exchange Interface.
HL7 Table of Vaccine Codes
view (52.8 KB, 2 pages)
Vaccine Code table.
Paper Reporting Form
Immunizations are to be reported within 14 days of administration according to the NYC health code. Providers fill out demographic and immunization information and mail original (white copy) reporting forms with a completed Batch Submittal Form. Please use the contact information below to send completed immunization registry reporting forms and to order forms for your office.
New York Citywide Immunization Registry
P.O Box 90490
Binghamton, NY 13902
Email: cirforms@srcp.com
Tel: (800) 238-0130
Fax: (212) 208-4641
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Order Online
User Confidentiality Statement for Online Access
and Acceptable Use Protocol
view (160 KB, 2 pages)
To access the Online Registry (OR) through the website, each health care facility or practice designates a Security Administrator. The Security Administrator must read, sign and mail or fax the Security Confidentiality Statement for Online Access to the OR. He or she must also have each of their users read and sign a User Confidentiality Statement for Online Access and keep those on file at the site.
UPIF Provider's Guide
view (614 KB, 47 pages)
The Universal Provider Interface Format (UPIF) has been defined to provide a standard mechanism for the batch transfer of information between immunization providers and the Registry.
Web File Repository Guide
view (269 KB, 3 pages)
Guide for uploading electronic extracts of immunization data via a secure electronic file transfer to the Web File Repository (WFR). For more information and technical assistance, call us at (212) 676-2323.
Mail:
New York City Department of Health and Mental Hygiene
Citywide Immunization Registry
125 Worth Street, CN #64R
NY, NY 10013-4089
Phone: (212) 676-2323
FAX: (212) 676-2314
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