Hospital Demographics

  Please tell us about your current Point-of-Care testing program.   
Print this page, complete the information and bring it to the next CVPOC Meeting.

Name
Title
Institution
Address
City
State
Zip
Telephone
Fax
Email
Please check all tests that are currently part of your Point-of-Care testing program
Glucose Pregnancy testing Spun hematocrit
Drugs of Abuse Hemoglobin Urine dipsticks
Cholesterol testing Urine specific gravity Fecal/Gastric Occult blood
Blood gases Coagulation testing/PT Electrolytes
aPTT Streptococcus Screen ACT
Monospot test Nitrazine pH KOH/Wet Mounts
Fern Testing Other
Does your institution have a central Point-of-Care testing committee?    
YES   NO
If yes, what disciplines and departments make up this committee?  ( check all that apply)
Laboratory Hospital Administration Legal Affairs
Materials Management Quality Improvement Officer Infection Control
Medical Staff Nursing and nursing education
Other (please specify) 
 

Return to CVPOC Home Page

Return to PointofCare.net Home Page

Last updated: 10/04/2002
Questions or corrections: Webmaster