• Due to our recent software migration the TCR is making every effort to finalize and
    verify all data submission uploads. To ensure we are not missing anyone’s submissions,
    we are asking that you please update us with the total number of records you have
    submitted for admission years 2010 and 2011. 

     

    Facility/Institution Name* 

    TCR Facility ID Number* 
    Street Address* 

    City*      State*      ZIP* 

    Health Service Region Map
    Health Service Region* 

    Primary Contact Name* 
    Position or Title* 
    Phone Number (with area code)* 
    E-mail Address* 
    Alternate Contact Name (if available) 
    Alternate Contact E-mail Address 
    Alternate Contact Phone Number 


    Total Number of cancer records submitted to Texas Cancer Registry
    2010 Admission Year*      Date of last submission*       
    2011 Admission Year*      Date of last submission*     


    TCR is not yet ready to accept 2012 admission year cancer records but please
    tell us how many have been abstracted and are ready for submission as soon as
    we notify you that we are accepting these records.

    2012 Admission Year*     



    Fields denoted with an asterisk (*) are required to submit form.

     

     

Last updated August 22, 2012