TVFC and ASN Re-Enrollment Center

TVFC ASN Re-enrollment Center

DSHS requires all Texas Vaccines for Children (TVFC) and Adult Safety Net (ASN) program sites to re-enroll annually by completing a program agreement. Completion of this program agreement is due by October 31, 2019

Prior to starting your 2020 re-enrollment for TVFC and ASN, gather the following information:
  • Signing Clinician’s name, title, email, medical license number and NPI
  • Primary and backup vaccine coordinator’s name, title, email and phone numbers
  • Primary and backup training certificates from the most current TVFC/ASN Provider Policy Training - 
  • List of all practitioners at your site with prescribing authority to include name, title, medical license and NPI
  • For TVFC: Number of children vaccinated in your facility in the previous 12 months, separated by age groups in the following categories:
    • Enrolled in Medicaid or Medicaid-eligible 
    • UNinsured
    • American Indian/Alaskan Native
    • UNDERinsured 
    • Enrolled in CHIP 
    • Insured – This information serves as verification for the accountability of TVFC/ASN Program 
  • For ASN: Number of UNinsured and insured adults that were vaccinated in your facility in the previous 12 months 
  • Facilities that are a Federally Qualified Health Center (FQHC) or Rural Health Center (RHC) must also submit a copy of the Centers for Medicare & Medicaid Services (CMS) letter designating the sites as such. This will be required to uploaded. 
Tips for completing the TVFC and ASN Programs Re-Enrollment
  • Ensure you are using Chrome or the latest version of internet. Some functions may not work properly if you do not have the latest version of internet.
  • After entering your password, you will be asked to enter your six-digit TVFC/ASN PIN. You must enter “TVFC” prior to your pin. (“TVFC123456”)
  • Do not use the web page back arrow button at the top left of your screen when filling out this document. It is important to go to the bottom of the page to use the back arrow to return to the previous page.
  • Words with asterisks (*) located next to it have a definition or description. A pop-up box will appear when you hover over (place the mouse over) the word.
  • If you need to gather data and come back to continue the survey later, simply close the web browser window. To return to the survey, click on the link you received, and you will be directed to the point in the survey where you left off (only if you return to the survey using the same computer that you started on). If you return to the survey using a different computer, you will be required to complete the survey from the beginning. Please contact your Responsible Entity if you have issues completing the survey.

    Thank you for your continued support of the TVFC and ASN Programs, and for keeping Texans healthy by preventing and controlling vaccine-preventable diseases. We hope your re-enrollment is a success. If you have any questions, please contact your Responsible Entity.

Last updated November 8, 2019