CATRAC Requests

CATRAC Request Form

CATRAC Request Form

Requestor Name Requestor Title Requestor Email Requestor Phone Requestor Agency Request Type

Membership Forms

Organization Contact Update Form

Used to keep your organization’s contact information current, ensuring accurate communication and proper tracking of committee and workgroup participation.

Designated Member Representative Form

Used to designate the primary individual who will represent your organization for general membership participation and voting.

Trauma Medical Director Designee Form

Used to assign a Trauma Medical Director designee in accordance with Texas requirements for trauma-designated facilities and trauma workgroup participation.

Data Request Form

Used by stakeholders to request aggregate data for presentation or discussion at a committee or workgroup, subject to Data Committee review.

Case Review Request Form

Used to submit cases involving potential regional barriers or concerns for review by the closed PI committee, with resulting recommendations shared to improve patient care across the region.