We welcome you to become an NDNQI® hospital participant, an important step for achieving improvements in your patient safety and quality efforts.

To receive a hospital enrollment application, we ask you to provide us with your contact information plus a valid hospital email address. Email is the primary means of communication between NDNQI and your hospital. In addition, NDNQI program staff will use the application to determine hospital bed size composition for pricing.

Please provide us the following information so we may process your application quickly and contact you if necessary.

Note: If your hospital is already an NDNQI participant do not complete this application. This application is for new hospitals only.

First Name:* Last Name:*
Hospital Name:* Number of Hospital Staffed Beds:*
System Affiliation: Number of System Staffed Beds:
Email Address:* Confirm Email Address:*
Telephone: (xxx-xxx-xxxx)*



In which calendar quarter is your hospital planning to get started?*
Please Select One
1st Quarter
2nd Quarter
3rd Quarter
4th Quarter
I need help with the Pressure Ulcer Training Course






For questions or more information about joining NDNQI, Please Contact   For problems or issues with Pressure Ulcer Training, Please Contact
Michael Grove
NDNQI Account Manager
301-628-5042
          
NDNQI Help Desk
913-588-1691