Group Membership Form

National Network of Child Death Overview Panels

Group Membership Form

Name of CDOP: *
Is this a group of CDOPs? Yes / NO*
If yes, list participating areas:*
Annual number of child deaths reviewed (2014) : *
Number of CDOP meetings per year (2014): *
Is the CDOP meeting for a whole day (6/7 hours) or part of the day?: *
Total number of CDOP hours per year (2014): *
Are neonatal reviews undertaken separately by the CDOP? : Yes / No *
Is there another forum which reviews child deaths before the CDOP meeting? : Yes / No*
Is there another forum which reviews neonatal deaths before the CDOP meeting? Yes / NO:*
Do you have joint meetings with other regional CDOPs?: Yes / No *
If yes, how often are the meetings held?: *
If yes, list the participating regional CDOPs : *

CDOP Co-ordinator/Administrator

Name:*
E-mail Address:*
Telephone:*
Mobile No:*

CDOP Chairperson

Chairperson Name:
Chairperson E-mail Address:
Chairperson Telephone:
Chairperson Mobile No:
Word Verification:
* Indicates required fields

* Group membership application approved by the members of the CDOP