If you would like to join the ABCD nationwide FreeStyle Libre audit and are based in Ireland, simply complete and submit the form below. Your Details Title * - Select -Dr.ProfessorMr.Mrs.Ms.MissAssociate ProfessorThe Right Honourable Lady First Name * Last Name * Designation * - Select -Consultant PhysicianConsultant PaediatricianSpecialist RegistrarGPPractice NurseSpecialist Nurse Practitioner (Diabetes) - Hospital/Community careSpecialist Nurse Practitioner (Diabetes) - Primary/Community careDietitianRetired healthcare professionalCommercialOther (please specify) Designation (other) Are your patients Adult Paediatric Adult and Paediatric Town * The town in which the hospital or surgery is based Name of Trust in Full (no acronyms) * Hospital / Institution * Country * United KingdomAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo, Republic Of TheCongo, The Democratic Republic of theCook IslandsCosta RicaCôte d’IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSerbia and MontenegroSeychellesSierra LeoneSingaporeSint Maarten (Dutch Part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe County * - None - Phone Number * Email * How we will use your data In order to join the audit you need to agree that the audit organisers are allowed to see all the details above about you and your site/centre. The audit organisers will be analysing only anonymised patient data but they are not prepared to receive data from anonymised contributors. Please tick the boxes to agree to this and that we may contact you at any time about anything to do with this audit and to invite you to join future audits that might be applicable to you. Opt in I agree that ABCD may contact me at any time about this audit Group(s) I would like to be invited to join future audits that might be applicable to me Further Information About text formats Plain text No HTML tags allowed. Web page addresses and email addresses turn into links automatically. See section headed structure of the audit - centres and sites on the audit main page. If you would like to let us know at this stage about the structure you were thinking of for your location by all means do so in the box below. The centre can however be further developed at any stage in the future, with sites added at any time. Member Details
