Waco-McLennan County Public Health District

Waco-McLennan County Public Health District

Texas Public Health Information Network (PHIN)

The Texas Public Health Information Network (PHIN) is a nationwide initiative led by the Centers for Disease Control and Prevention. In Texas, the PHIN is a joint collaboration between the Texas Department of State Health Services and the Texas Association of Local Health Officials. The PHIN includes a number of data and communication tools, including a private access database of key health contacts with a system to rapidly disseminate health alerts.

This is an invitation to be registered on the Texas HAN as a key health contact. I have an email address and agree to have my individual contact information on the PHIN.
Signature:		Date:
First Name:		Last Name:
Title:		Work Phone:
Work Place:
Work Address:		City:	State:	Zip:
Work Email:		Work Fax:		Cell Phone:
Pager:		Alternate Email:		Home Phone:
Home Address:		City:	State:	Zip:
Occupation- Please choose up to 3
Administrator, Other		Fire/Hazmat	Pediatrician
Agency Commissioner/Director		Food Services	Pharmacy
Attorney		HAN Administrator	Physician
BT Planner		Health Authority	Physician Assistant
BT Surveillance		Homeland Security	Program Manager
Clerical Support		Hospital	Public Information
County Commissioner		Infection Control Specialist	SNS Coordinator, Local
County Judge		Infectious Disease Specialist	SNS Coordinator, Reginal
Mayor		Lab	SNS Volunteer
County Coroner/ Morgue		Law Enforcement	School Nurse
Daycare		Mental Health	School Official
Emergency Management:		Network Support Specialist	Social Worker
Emergency Medical Services		None	Translator
Epidemiology		Nurse	Veterinary/Zoonosis
Epidemiology Response Team		Nurse Practioner	Vital Statistics
		Other Health Professional	Volunteer
		Paramedic
Professional Education
MD	EMT MPH	Epidemiology	Paramedic
DO	RN LVN

Professional Education