Get Denominator Information Form

Filling out the Denominator Information Form accurately is essential for submitting important data regarding influenza surveillance in hospitalized adults. This guide provides clear, step-by-step instructions to help you navigate the form online.

Follow the steps to complete the Denominator Information Form

1. Click the ‘Get Form’ button to access the Denominator Information Form and open it in your online editor.
2. Start by entering your CHEC number in the designated field at the top of the form. This is crucial for identifying your submissions.
3. Next, provide the total number of inpatient admissions for adults only. This number should reflect your hospital's specific definition of adult admissions.
4. Fill in the total number of inpatient days for adults only in the following field. Similar to the previous step, ensure that it aligns with your hospital's guidelines.
5. Indicate the total number of influenza tests performed in your hospital by entering the number in the provided space. Make sure to include only those tests relevant to your institution.
6. Specify whether duplicates are included in the total number of tests performed by selecting 'Yes' or 'No'. This helps clarify the data being submitted.
7. After completing all fields, review your entries for accuracy. Ensure that all information is correct before final submission.
8. You can now save changes, download, print, or share the completed form as needed to finalize your submission.

Complete your Denominator Information Form online today to ensure timely and accurate data submission.