If you would like to join the ABCD Nationwide Covid-19 and Diabetes Audit, 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) Town * Postal Code * Centre name in full (Hospital trust, ICS etc) * Please provide the full name of your NHS Trust/CCG (centre) and Hospital/GP Practice (site). Please do not abbriviate. Site name in full (Hospital, GP surgery etc) * Phone Number * Email * For security purposes, this audit requires an NHS 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 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.