Texas Cancer Registry Training Request Form Fields denoted with an asterisk (*) are required to submit form. Facility/Institution Name: TCR Facility ID: Type of Facility* - Select -HospitalAmbulatory Surgical CentersCancer Treatment CenterPhysicians OfficePathology Lab Are you currently reporting to the Texas Cancer Registry? Yes No Primary Contact Name* Position or Title* Phone Number (include area code)* Email Address* Alternate Contact Name (if available) Alternate Contact Email Address Alternate Contact Phone Number Fax Number Street Address* Street Address* City* State* - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP* Public Health Region* (Look up your Public Health Region.) Date Training Requested* (Please allow at least 4 weeks notice.) Type of Training Requested* (Select) - Select -Basic TrainingSpecialized TrainingSoftware Training Number of Attendees* Reason Training Needed* - Select -New ReporterNew Reporting FacilityAdditional Training-Refresher-RetrainingOther-specified in text box below Specify if Other CAPTCHA Math question 17 + 3 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit Leave this field blank Book traversal links for Training Request - TCR ‹ Education and Training - Texas Cancer Registry Up Training Events › Texas Cancer Registry Texas Cancer Registry Education and Training - Texas Cancer Registry Training Request - TCR Training Events NAACCR Webinars Open submenu links Close submenu links Webinar Attendance - TCR Training Resources 2024 Cancer Reporting Guide 2023 Cancer Reporting Guide 2022 Cancer Reporting Handbook 2021 Cancer Reporting Handbook