The following questions may ask you to use computer interactions or information about the NCIR that you may not be familiar with, if you have trouble with a question just skip it and move on.

1. How familiar do you feel you are you with NCIR?

Not at all familiar		Somewhat familiar		Extremely familiar
1	2	3	4	5

2. How often do you use online forms on a weekly basis?

Select One... Never Sometimes Frequently Always

3. In the NCIR menu, what two ways are available to access client records for entering historical immunizations?

	Manage Users
	Manage Immunizations
	Manage Vaccines
	Manage Clients
	Manage Inventory

4. What three pieces of information from a Vaccine Administered Log are needed to search for a client's record?

	Birth Date
	Mother's First Name
	Last Name
	Gender
	First Name
	Service Date

5. Can you point to where these three pieces of information are on a Vaccine Administered Log?

	Yes
	No

6. What does the following icon, found in the NCIR, do? 

	Enters Notes About a Client
	Interactive Calendar for Dates
	Edits Client Information
	Saves the Client Information

7. What does the following icon, found in the NCIR, do? 

	Enters Notes About a Client
	Edits Client Information
	Saves the Current Immunization
	Selects the Current Immunization

8. Which of the following is a Client-Specific Report that can be generated in NCIR?

	Inventory Report
	Assessment Report
	Immunization Record
	Reminder Notice

9. What does the following icon, found in the NCIR, do? 

	Edits the Current Report
	Prints the Client's Information
	Saves the Current Report
	Enters Notes About a Client

10. What information is needed to Generate a Client-Specific Report?

	Provider Organization
	Verification Date
	Ordering Authority
	Current Site

11. What two pieces of information can you find in a Client-Specific Report?

	Client Eligibility
	Ordering Authority
	Inventory at Current Site
	Date Administratered