If you would like to join the ABCD nationwide FreeStyle Libre audit and have access the secure audit tool on the NHS network which will allow local analysis and storage of your own data as well as automatically providing the data in anonymised form to the nationwide 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)Pharmacist Designation (other) Are your patients Adult Paediatric Adult and Paediatric Town * The town in which the hospital or surgery is based Postal Code * Type of registration NHS Trust Primary Care Primary Care registration requires a named GP practice. Centre name in full (Hospital trust, ICS etc) NHS trusts require a named hospital site Name of Trust in Full (no acronyms)* Name of ICS in Full (no acronyms) Surgery*If you want to register multiple GP practices, please include each GP practice. Hospital*If you want to register multiple hospital sites within a Trust include each hospital. Hospital Phone Number * NHS email * Please note, only the following email addresses are allowed – nhs.net / nhs.uk / .ac.uk 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. 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.
