This booklet is designed to gather patient data that will later be entered into eNICQ. There are different booklets for VLBW and for Expanded centers. This booklet is for Expanded centers. Data Items are in the same order in the booklet as they are in eNICQ.
This booklet should be printed double sided on 11" x 17" paper and then folded in half.
The booklet must not be submitted to VON. There is protected health information on every page of the booklet.