AIM Hospital Team

Your AIM Team

Question Title

* 1. Which bundle(s) will your team be working on?

Severe HTN/Preeclampsia

Obstetric Hemorrhage

Question Title

* 2. Please list the main hospital contact for the AIM project

Contact Name

Contact Title

Hospital Name

City/Town

Contact Email Address

Contact Phone Number

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* 3. List additional team members below.
Include full name and email address.
For 'others' include name, team role, and email
(e.g. Angela Centellas, AIM Data Coordinator, acentellas@njha.com):

Physician Lead

Nurse Lead

Quality Lead

Data Lead

Other1

Other2

Other3

Other4

Other5

Other6

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* 4. Do you have any comments or concerns?