Please report all information (unless otherwise specified) for a full 12-month period, January 1, 2006 through December 31, 2006.

**Note that different persons may be assigned to complete Parts A, B, and C (Obstetric Services) versus Parts D, E, F, G, H, I, J and K(Newborn / Special Care).

General Instructions:

• Log into the questionnaire using your username and password. Once logged in, all sections of the questionnaire will become accessible.
• Do not leave a page where changes have been made without first clicking Continue, or the changes made will be lost. A page can be submitted as many times as necessary.
• None of the fields can be left blank. If a number is required enter zero, or choose Not Applicable from the list.
• When the OB/Newborn Services Section is complete and has been checked for accuracy click on the End of OB/Newborn Services link. Complete this page and click Submit. This will generate an email notifying NPIC/QAS and your administrator that the questionnaire is complete.
• When finished with the questionnaire, click the Log Out link located either on the left navigation menu or located on the questionnaire completion pages. Once logged out only the Login, Glossary and Instructions are accessible, until re-logged in.

Definition of Terms:

• A glossary of terms is provided. Please refer to the definitions if you have questions regarding a specific term used in the questionnaire.
• To avoid losing changes made by leaving the page without clicking submit, click on the  located next to terms defined in the glossary. The definition of that term will appear in a pop up box.

Start the questionnaire:

       ·Start OB Services
       ·Start Newborn Services

***Questions regarding the questionnaire can be directed to adabrosca@npic.org or jmuri@npic.org or call 401-274-0650.