If you would like to join the ABCD nationwide exenatide qw audit and have access the secure audit tool on the latest version of NHSnet (N3) 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 * Postal Code * Type of registration NHS Trust CCG CCG registration requires a named GP practice. Name of CCG in Full (no acronyms)* NHS trusts require a named hospital site Name of Trust in Full (no acronyms)* Name of NHS Trust or ICS Hospital*If you want to register multiple hospital sites within a Trust include each hospital. Surgery*If you want to register multiple GP practices within a CCG include each GP practice. Hospital / Institution Phone Number * N3 Server 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. Group(s) I would like to be invited to join future audits that might be applicable to me I agree that ABCD may contact me at any time about this audit 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.
