Sample Sidebar Module

This is a sample module published to the sidebar_top position, using the -sidebar module class suffix. There is also a sidebar_bottom position below the menu.

Sample Sidebar Module

This is a sample module published to the sidebar_bottom position, using the -sidebar module class suffix. There is also a sidebar_top position below the search.
Register as a Pharmacy Business

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Pharmacy Account Creation

Please complete this form to set yourself up with an account on the system

Once your account has been approved, you will be able to add your Pharmacy locations to the site.

- Please enter a value

Primary Contact

- Please select your title

- Please enter a value

- Please enter a value

- Please enter a value

- Please enter a value

- Please enter a valid email address

- Sorry, that address already exists - if you already have an account with us, please try using the remember password option

- Please enter a value

- Please enter a value

- Passwords do not match

Business head office address and Contact details

- Please enter a value

   
 

- Please enter a value

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- Please enter a value

- You must agree to the terms before continuing.

Register as a Locum

Welcome to the Locum Connect Locum Registration Form.

Before you get started, here is a list of the information you will need to complete this form.

  • A scan of your eligbility to work in the UK e.g. Passport photo. This can be in an image format such as jpg or as PDF or Word Doc
  • A scan of your Liability Insurance Certificate . This can be in an image format such as jpg or as PDF or Word Doc
  • Your GPHC registration number

- Please select your title

- Please enter a value

- Please enter a value

This will be your username for the site

- Please enter a value

- Please enter a valid email address

- Sorry, that address already exists - if you already have an account with us, please try using the remember password option

- Please enter a value

- Please enter a value

- Passwords do not match

Address and Contact Details

- Please enter a value

   
 

- Please enter a value

- Please enter a value

- Please enter a value

- Please enter a value

Registration Details

- Please select a value

- Please enter a value

- Please enter a value

Medicines Use Review Accreditation
CPPE Level 2 Safegaurding Accreditation
New Medicines Service Accreditation
DBS Check
Independent Prescriber
Flu Vaccination Accreditation
Dementia Friends Accreditation

- Please upload proof that you are eligble to work in the UK

- Uploaded file must not have apostrophes or commas in file name

- Please upload a copy of your current Indemnity Insurance

- Uploaded file must not have apostrophes or commas in file name

ProScript Link
Pharmacy Manager
NexPhase
Analyst PMR
Proscript
Other

- Please enter a value

Fitness to Practise

- Please select a value

- You must be registered with the GPHC to continue on this site

- Please select a value

- Please specify details of the Fitness to Practise issue

- Please select a value

- Please specify details of the health issue

Mailing Options

We can send you an email listing available shifts in your area. Please tick either of both of the options below if you would like to receive this.

Yes please send.
Yes please send
Hide my details

Locum Connect Terms of Use

- You must agree to the terms before continuing.

Subcategories

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