Participation in Sentinel Network

If you want to participate in Sentinel Network, that is to say to share the personal data of the patients who have given birth in the maternity unit or of the newborns hospitalised during one month every year or during the whole year, please fill in the following form.

Identification

Title

Dr

Pr

Mrs

Mr

Last name

First name

Hospital*

Service

Number of childbirths

/year

Number of hospitalised children

/year

Residence

Address

Address (supplementary information)

Zip code

City

Phone

Fax

Email

Complementary data

Do you use a structured obstetrical file ?

Yes

No

Display the AUDIPOG files

Do you have a computerisation of the medical data ?

Yes

No

Display the list of softwares labeled AUDIPOG

Who is in charge of informatization in your service ?

Last name

First name

Phone

Email

Participation in Sentinel Network

How ?

By sending a copy of the computer file of the service

By capturing data on the AUDINET capture module

By capturing data on the AUDIPOG website

By manual data capture on paper sheets, while waiting for computerisation

3 ways to have access to the site Obstetrical minimal file Obstetrical-pediatric minimal file Neonatal minimal file only

Participation

At least a month a year

The whole year

2 types of files are available Minimal obstetrical sheet Minimal obstetrical-pediatric sheet

Participation for

Number of sheets wished

Conformément à la loi n° 78-17 du 6 janvier 1978, relative à l'Informatique, aux fichiers et aux libertés, vous disposez d'un droit d'accès et de rectification des informations nominatives vous concernant. Vous pouvez l'exercer en vous adressant à mail