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Locum Form

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Full Name* Phone Number* Email Address* Select Role*

Organisation or Agency Name* Your Role in the Organisation*

Professional Registration Number (GMC/NMC/GPhC)*

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Are you remote-ready?* ℹ️

Additional useful services and tools

Select any additional services:

General IT Support Smartcard support PCN and GP Websites Other None

Services you'd like a quote for:

New laptop + Setup + HSCN token Leased pre-configured laptop Personal laptop setup + VPN Practice website setup General IT support Smartcard support EMIS/SystmOne configuration

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What does remote-ready mean?

You already have a compliant personal laptop or one provided by your employer or leased, with HSCN VPN access and NHS software installed.

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Your interest has been registered. Our team will get back to you regarding any additional services requested