NHSmail account registration form for Pharmacies, Optometrists and Dentists Please provide evidence that you have completed the IG toolkit by sending an assessment report/certificate with your application (one is sufficient per practice). For further information see: If information is missing from application form this may prevent us from creating account. Part 1 – NHS Mail Account Creation 1. Name: 2. Role: 3. Current Existing Email address: 4. Organisation name and address: 5. Organisation data 6. service (ODS) code ** Organisation : telephone number: 7. *Pharmacists – GPhc registration number: *Please note that we require your Organisation Data code and your *Optometrists – GOC registration number: professional registration number. If these are not completed form will be returned. *Dentists – GDC registration number: 8. Does your organisation 9. If yes, please already hold any NHSmail provide the email accounts? Y/N address/es: All sites are limited to 3 accounts per site. 2 Individual Accounts and 1 Shared mailbox that will be named in a company/StoreType.town/street@nhs.net format that will be easily identified: Example : 10. Details of accounts required, full name and mobile number for each account owner: 11. Do you require a shared mailbox for your organisation? Please also confirm the account owner name and mobile number:
NHSmail account registration form for Pharmacies, Optometrists and Dentists Please provide evidence that you have completed the IG toolkit by sending an assessment report/certificate with your application (one is sufficient per practice). For further information see: If information is missing from application form this may prevent us from creating account. Part 1 – NHS Mail Account Creation 1. Name: 2. Role: 3. Current Existing Email address: 4. Organisation name and address: 5. Organisation data service (ODS) code ** : 6. Organisation telephone number: 7. *Pharmacists – GPhc registration number: *Optometrists – GOC registration number: *Dentists – GDC registration number: *Please note that we require your Organisation Data code and your professional registration number. If these are not completed form will be returned. 8. Does your organisation already hold any NHSmail accounts? Y/N 9. If yes, please provide the email address/es: All sites are limited to 3 accounts per site. 2 Individual Accounts and 1 Shared mailbox that will be named in a format that will be easily identified: company/StoreType.town/street@nhs.net Example : 10. Details of accounts required, full name and mobile number for each account owner: 11. Do you require a shared mailbox for your organisation? Please also confirm the account owner name and mobile number:
FINAL-version-PODs-NHSMail-Registration-Form.docx