Get Cpqcc & Hrif-qci Directory

This guide provides clear instructions on how to effectively fill out the CPQCC & HRIF-QCI DIRECTORY online. Follow the steps outlined below to ensure all required information is accurately entered and submitted.

Follow the steps to complete the directory form with ease.

1. Click the ‘Get Form’ button to access the directory form and open it for editing.
2. Begin by entering your facility's name and address. Make sure to include the street address, city, county, and zip code for accurate identification.
3. Provide the phone number of the facility, ensuring that the area code is included.
4. Enter the OSHPD facility code, which is essential for state recognition. This code typically consists of five digits.
5. Indicate the CCS NICU level according to the guidelines set by the appropriate health authorities. This is important for categorization.
6. Specify the healthcare region your facility belongs to, as per the regional classification.
7. Indicate whether your facility provides HRIF program onsite or refer patients to another facility for these services.
8. For the CPQCC member contacts, fill in the report contact's name, title, address, phone number, and email.
9. Continue to fill out the HRIF program contacts, entering the names, roles, and contact information for the neonatologist, HRIF coordinator, and medical director.
10. Make sure to provide data contacts' details, including their position and how to reach them.
11. After filling out all sections, review the information for accuracy and completeness.
12. Once confirmed, save the changes and choose to download, print, or share the completed form as needed.

Complete the CPQCC & HRIF-QCI DIRECTORY online today to ensure your facility's information is up to date.