Contact

Surname (required)

Forename (required)

Job/Course Title (required)

Work Address

Work/Course Email (required)

Employing Authority/College/University (required)

Contract/Placement/Course Expiry Date

Home Address (required)

Contact number (required)

I have read the library privacy policy and agree to this data being held in accordance with the General Data Protection Regulation (2018) for use in the library system shared by NHS libraries in the South West, Thames Valley and Wessex.

I have read the library regulations and agree to abide by them.

Your Name: (required)

Area of Work: (required)
AHPNurse/MidwifeMedicOther
If you selected 'Other' please specify:

Department: (required)

Email: (required)

Phone number:

Please provide a brief outline of your clinical question/project idea: (required)

Have you received any research advice to date? (required)
YesNo
If yes, please provide a brief outline: