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             A CMS Qualified Clinical Data Registry since 2014 - QCDR

  Acute Facilities

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Acute Facilities -  COVID19 Tools Signup Form

To better help us expedite your requests for CDC required COVID19 patient abstractions, please fill in the questionnaire below.

This will expedite our support for your organization's COVID19 reporting process.

 
The following information will enable us to contact you.

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Point of contact - Administrator

First Name:                                    
Last Name:                                    
Email address:                               
Phone (Include Extension)               
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Hospital/Facility name          
Address                               
City                                     State 
Zip code                              

Please answer the questions below as best you can. 

 1. What is the type of ICU   


 2. Do you currently have COVID19 patients admitted to in your ICU? Yes No


 Item 3 - 9 TBD in future survey

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10. Please enter below any additional information that you would deem helpful.

 

 
 
 CUHSM.ORG

        Consortium for Universal Health System Metrics -      A CMS Qualified Clinical Data Registry since 2014 - QCDR
 
More information at these links:
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Contact Us

For more information, contact us via email at clientservices@cuhsm.org

Phone:  (888) 979-2499 x2

Universal Health System Metric Tools referenced on this site:
CMS Submission Toolkit, CST-CMS Submission Template, PQRS Audit Tool, PQRS Validator, GPRO Aggregator,
    QCDR-HISP, QRDASolutions, and NwHIN Sleuth are trademarks of CMS Gateways, LLC
All other products mentioned are registered trademarks or trademarks of their respective companies.

QCDR-HISP = Qualified Clinical Data Registry - Health Information Service Provider

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Last modified: Monday April 06, 2020.