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SPACARB_Liste
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* Indicates required question
NOM
*
Your answer
Prénom
Your answer
Courriel
*
Your answer
Fonction
*
Your answer
Nom de l'établissement
*
Your answer
Type d'établissement
*
Choose
CH
CHU
Hôpital Privé
Clinique
EHPAD
SLD/SR
Activité du site
MCO
Psychiatrie
SSR
SLD
EHPAD
Autre
Catégorie de l'établissement
*
(selon ICATB)
CHU / CH >= 300 lits
CHU / CH < 300 lits
Clinique >= 100 lits
Clinique < 100 lits
CLCC
uniquement SSR/SLD
Hôpital local
Required
VILLE
*
Your answer
Code Postal
*
Your answer
Code FINESS
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