Infection Prevention Registry

If you are practicing as an infection preventionist (IP) in North Dakota, please take a minute to complete the following questions to assist the NDDoH with compiling a current IP contact list.

The list will be used to create an email distribution list to assist in sharing communications regarding upcoming meeting dates and/or minutes, trainings, new guidelines, articles of interest and updates pertaining to infection prevention in healthcare. 

Working together, we can continue to prevent the spread of infections!


Primary Contact #


First Name   Phone Number  
Last Name   Email  
Title

Secondary Contact #


First Name   Phone Number  
Last Name   Email  
Title

Facility Information:


Facility Name  
Facility Type   Other
Facility Address  
City   State   Postal Code  
# of beds
Is the facility accredited?
Accrediting Organization
Licensing Organization