Get Arkansas Immunization Registry

This guide provides a clear, step-by-step approach for users looking to fill out the Arkansas Immunization Registry online. Whether you are a healthcare provider or an authorized personnel, this guide will assist you in submitting vaccination records accurately and efficiently.

Follow the steps to fill out the Arkansas Immunization Registry form effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the MSH segment of the form, ensuring to include the field separator correctly using the pipe character ‘|’. Include the required encoding characters value of ‘^~\&’.
3. Input the unique Sending Application and Sending Facility IDs assigned to your system to ensure proper identification.
4. Complete the PID segment by entering the patient's identifiers, ensuring that required fields such as patient name and date of birth are filled accurately.
5. Include the vaccination details in the RXA segment, specifying the administered code and amount along with any necessary comments related to the vaccination.
6. Make sure to review all entries for accuracy, especially the message type, before finalizing your submission.
7. Once all required fields are completed, submit the form, and ensure to save any confirmation or acknowledgment received from the registry.

Complete your vaccination records submission online to maintain accurate immunization data for Arkansas.