SNUG Member Registration

Please complete this form to register for SNUG Website Membership. Once I receive your registration and make sure your Practice is a fully subscribed SNUG Member, I will activate your account. If your Practice is not a SNUG Member please also fill in SNUG Standing Order Mandate.doc. For questions, or issues with SNUG Membership Registration, please contact: alexandra.defranco@nhs.net

Username

(lowercase, no spaces, eg: johnsmith)

Email Address

Password

(your preferred choice of password)

Confirm Password

First Name *

Last Name *

GP Practice/Organisation Name *

Practice Address *

Address 1

Address 2

City

State/Province

Country

Postal Code

Telephone *

NHS Board Area

Health Board Cypher Number

Job Title

... Other (Job Title)

Are you using (or migrating to) EMIS?

Yes

Are you using (or migrating to) Vision?

Yes

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