Kansas Trauma Registry Helpful Forms and Documents

Helpful Forms and Documents

Please utilize these helpful forms and documents to aide your facility in collecting and analyzing trauma data at your institution's site. Please feel free to share helpful forms, documents or queries that you develop with KDHE to post on this website. Please email KTR@kdheks.gov with forms you would like to share.

Software Change Request Form

We appreciate your support and suggestions for improving the Kansas Trauma Registry software, Collector. Please utilize the software change request form when requesting a change to the current Collector software. New software versions are typically released in June, so changes requested will need to be dated prior to December 31 to make the following June release. You may either email your change request to KTR@kdheks.gov or fax to (785)296-1231 or mail to Kansas Trauma Program, 1000 SW Jackson Street, Suite 340, Topeka, Kansas 66612. All requests for software change will be reviewed for possible inclusion in the software. Changes requested are not guaranteed to be adopted.
Software Change Request Form (MS Word Version
| Software Change Request Form (Adobe Acrobat Version)