Are you trying to register one of these sites?

Site # ICU Name Hospital Name City Country

None of these are my site

FCICU Logo Family Satisfaction in the Intensive Care Unit Questionnaire: FS-ICU 24R

FS-ICU 24R - Site Registration Form

For the fillable text forms, please avoid using accents (e.g. “ô”) or any special characters (e.g. “/”), with the exception of a hyphen (“ -”).
Required fields are marked with a red asterisk (*)

For instructions on completing this form click here


* 1. Primary REDCap Users (Usernames and passwords to access the online data entry system will be assigned to each of the individuals listed below.)

First name Last name Email Telephone Role in ICU  

To register your site, please provide the following information.


Hospital Information

*


*


*




*


*


ICU Information


*


*


*


*


*












*


*


*


*


*




* Checking this box:
  1. indicates that you have had the opportunity to read information about the survey and understand the purpose of the Family Satisfaction in the Intensive Care Unit Questionnaire: FS-ICU 24R.
  2. indicates you agree to share your de-identified data so that it can be compiled into a larger dataset which will be used to generate bench-marked site reports.
  3. indicates that you agree to administer the survey based off the standards set in our instructions.

For instructions on using REDCap and our surveys: click here