Joining the AUDIPOG

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Joining the AUDIPOG

The participation in the Maternity Units Sentinelle Network is free, exept if you join the AUDIPOG Association (annual subscription : doctor 50 € - midwife 25 €).


Identification

	* Required fields
	Title:		*
	Last name:		*
	First name:		*
	Maternity unit:
		Number of childbirths per year:
	Neonatology service
		Number of hospitalised children per year

	Address:		*
	Zip code:		*
	City:		*
	Tel:		*
	Fax:
	E-mail (personal or professional) :		*


Complementary data

	Do you use a structured obstetrical file:
		If yes:
		If you use another file, which one:
		If not, would you choose such a file:
		Which one:
>>> Display the AUDIPOG files

	Do you have a computerisation of the medical data:
		If yes, which software do you use:
		If not, Do you foresee to acquire such a software :
		Which one:
>>> display the list of softwares labeled "AUDIPOG"

	Who is in charge of informatization in your service?
		Last name:
		First name:
		Tel:
		Fax:
		E-mail (personal or professional) :

	Write the result in FRENCH and in CAPITAL LETTER :

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