Alaska

Step 1: Please complete the below enrollment forms

• VacTrAK New Provider Application
• HL7 Data Exchange
• VacTrAK Healthcare Provider Contract
• VacTrAK Authorization to Add/Modify Users
• VacTrAK Interface Project Profile Form

Please return the forms directly to PrescribeWellness: iisforms@prescribewellness.com with the following subject line: Pharmacy Name/Vaccinations/AK Registry Enrollment Forms

Step 2: Kick-off call with AK registry

• PrescribeWellness will reach out and find which days/times the pharmacy is available for registry call (2-3 dates)
• PrescribeWellness will submit the form to the registry along with the pharmacy’s availability
• AK registry will schedule this call with the pharmacy.

Step 3: Documenting in the Vaccinations tool and Testing

• Please document all administered immunizations in the OutcomesVaccinations Tool.
• After the kickoff call, AK registry will assign the interface credentials
• The pharmacy needs to send the interface credentials to iisforms@prescribewellness.com. The pharmacy will then go into active testing.
• While in active testing, please document directly to the AK registry and in the Outcomes Vaccinations Tool.

Step 4: Final Steps

Outcomes will notify your pharmacy with a confirmation email once the pharmacy has been approved for production and is live to report to the AK registry with the Vaccinations tool.

If you have any questions, please call us at 1-877-237-0050.