CDR/FIMR Prevention and Activity Tracking Question Title * 1. Date: Question Title * 2. Review Team: Child Death Review Team Fetal Infant Mortality Review Team Wisconsin Child Death Review State Advisory Council Question Title * 3. County: Ashland Barron Brown Buffalo Burnett Chippewa Clark Columbia Crawford Dane Dodge Door Douglas Dunn Eau Claire Florence Fond du Lac Forest Green Jackson Jefferson Juneau Kenosha Kewaunee La Crosse Lafayette Langlade Lincoln Manitowoc Marathon Marinette Milwaukee Monroe Oconto Oneida Outagamie Pierce Portage Price Racine Rock Rusk Sauk Sawyer Shawano Sheboygan St. Croix Taylor Treampleau Vilas Walworth Washbrun Washington Ozqukee Waukesha Waupaca Waushara Winnebago Wood Not Applicable Question Title * 4. Lead Agency: Question Title * 5. Contact Person: Question Title * 6. Phone Number: Question Title * 7. Email: Question Title * 8. List risk factors that led to the activity, recommendations or outcome. Question Title * 9. List the activity, recommendations or outcomes that resulted from the team's case reviews. Question Title * 10. Is this activity, recommendation or outcome data-driven? If so, please describe. (For example, the team reviewed two teen suicides in 6 months). Question Title * 11. Is there a policy or practice local or state agencies should review as a result of this cause of death? Please explain. Question Title * 12. List outcome(s) that have resulted from the implementation of this activity or recommendation. Done