Cost Analysis Registration Form

LMC Buying Group Cost Analysis Registration Form

You will be contacted by a member of the LMC Buying Group team upon submission of this form. The cost analysis will be arranged and carried out remotely or by a practice visit. You will be asked to provide information on your current spending and will be provided with a cost savings report at the end of the process.
Organisation Name *
Organisation NHS Code (if applicable)
List Size (if applicable)

Address *

Street Address
Street Address Line 2
City	County
Postcode	Country

Phone Number *

- Area Code Phone Number
Your Name *

First Name Last Name
Your Role *
Your Email *
example@example.com
Are you responsible for ordering? *
If no, please provide contact details for the person responsible for ordering
Where did you hear about the cost analysis service? *
Is your practice a member of a GP Federation/working towards federating? *
If yes, would you like to find out how the Buying Group could help your Federation?
Federation Details
Federation name, contact details
Consent

Due to data protection regulation changes, we need to gain your explicit consent about what we can do with your 'personal data' (i.e. your name and email address) and the results of your cost analysis in future.
Personal Data *

I consent to my name and email address being stored on the Buying Group's members' database for administrative purposes. I consent to my email address being used by the Buying Group to send me occasional membership updates by email (this includes information about the annual flu offers and any changes to approved suppliers). I understand that if I tick this box I can still unsubscribe from these emails at any time. I consent to my email address being used by Buying Group suppliers to send me updates by email. I understand that I understand that if I tick this box I can still unsubscribe at any time.
Analysis Results *

I consent to the practice's cost analysis results being stored by the LMC Buying Group for administrative purposes only. I consent to the practice's results being used to help the Buying Group improve its cost analysis service. I consent to the practice's cost analysis results being anonymised and shared with other practices and third parties, as a case study. I consent to the practice's results being shared with other practices within my federation.
Privacy Policy
We will only use any information that you provide consistent with the principles of the General Data Protection Regulations. Where we ask for personal information (your contact details) this is to ensure we provide you with information that we believe is important to your membership and to help us and our suppliers identify if your practice is eligible for the deals we have negotiated. At no time will your personal information be shared with third parties unless you have given us permission to do so. Other information collected by us to complete the cost analysis will be held in the strictest of confidence and not shared with any third parties who have no right to it. *

I have read, understood, and accepted the PRIVACY POLICY.
Once you submit your application, we will contact you shortly with further information.

Thank you!
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LMC Buying Group Cost Analysis Registration Form

Consent

Privacy Policy