DCNS | Quality Improvement Rounds Attendance

Please submit this form for each Quality Improvement Rounds event you attend. Data will not be collected until you hit the SUBMIT button at the bottom of the form. Attendance data will be emailed to you at the end of each Ground Rounds season. Click here for email assistance.

Your Name
If your name is not in the list, please select "Other" at the end of the list and add your name.

Collection of personal information
Your personal information is collected under the authority of section 33(c) of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection or use of this information, please visit our Access to Information page.