INTEGRATE CIRCA site data overview
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Please record your data submission characteristics here.

More info here: www.entintegrate.co.uk/circa
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Other
Name of person completing form
Email of person completing form
Postcode of your hospital *
Distance (in miles) from your hospital to nearest CI centre. If you are a CI centre then please write '0'. *
Does your site perform cochlear implantation? *
Number of patients identified by Crystal Report (BEFORE excluding any patients) *
Before this audit, was your site routinely running the Crystal Report? *
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