Are you trying to register one of these sites?

Site # ICU Name Hospital Name City Country

None of these are my site

International Nutrition Survey 2018
Site Registration Form

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


*

*

*

*

*











*

*

*
  
  
  
  
  

   *

*

*

*



*

*
(check all that apply)




*

*

*

*
millilitres (ml)

*



* What range do you target?


(mmol/L = mg/dL x 0.0555)





Checking this box indicates that you have had the opportunity to read information about the survey and understand the purpose of the International Quality Improvement Project. Sharing of data allows us to compute site reports comparing statistics across participating ICUs. Only aggregated data will be shared: demographics and clinical information for individual patients will never be shared. Clicking this will also allow us to give credit to your hospital where appropriate, such as on our web page, in journal publications, and in press releases.