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Joining
We would be grateful if you would complete the following questions for our records
*Required fields
*
Vision User No:
THIN Practice Contact:
*
Contact Title
*
Contact Forename
*
Contact Surname
Email Address
Position in Practice
Address:
Practice Name
Address Line 1
Address Line 2
Address Line 3
Post Code
*
Telephone Number:
Fax Number:
PCO:
SHA:
Opening times:
Training Days:
1. Name of Practice Manager (if different from above)
2. Email address of Practice Manager (if different from above)
3. List Size
4. Number of GP WTEs (Whole time equivalents)
5. Number of GP principles (if different from above)
6. Are you a Training practice?
Please select
Yes
No
7. Are you a hosted solution?
Please select
Yes
No
If "Yes" who is your provider?
8. How long has your practice been computerised?
Please select
Less than a year
1-2 years
2+ years
9. How long have you had Vision?
Please select
Less than a year
1-2 years
2+ years
10. Which system did you use before Vision?
11. Please give the full name of all GPs and state whether they are
full-time or part-time:
Name
Sex
Status
Please select
Male
Female
Please select
Full-time
Part-time
Trainee
Please select
Male
Female
Please select
Full-time
Part-time
Trainee
Please select
Male
Female
Please select
Full-time
Part-time
Trainee
Please select
Male
Female
Please select
Full-time
Part-time
Trainee
Please select
Male
Female
Please select
Full-time
Part-time
Trainee
Please select
Male
Female
Please select
Full-time
Part-time
Trainee
Please select
Male
Female
Please select
Full-time
Part-time
Trainee
Please select
Male
Female
Please select
Full-time
Part-time
Trainee
Please select
Male
Female
Please select
Full-time
Part-time
Trainee
Please select
Male
Female
Please select
Full-time
Part-time
Trainee
12. Do the GPs use the computer in consultation?
Please select
All
Some
None
13. Do the GPs use paper medical records?
Please select
Regularly
Occasionally
Rarely or never
14. Do the nurses use the computer in consultation?
Please select
All
Some
None
15. Do the practice nurses use paper records?
Please select
Regularly
Occasionally
Rarely or never
16. Are computer entries made for the following data?
Home visits
Out of hours visits
Phone consultations
Locum surgeries
17. Do you receive electronic Pathology Results?
Please select
Yes
No
If "Yes" are they:
Histology
Microbiology
Chemistry
Haematology
Others
18. Do you scan in correspondence?
Please select
Yes
No
19. In which type of area is the practice?
Please select
Rural
Urban
Inner city
20. Do you contribute data to any other scheme(s)?
Please select
Yes
No
If "Yes" which scheme(s)?
21. Are you a dispensing practice?
Please select
Yes
No
22. Which type of payment would you prefer?
Please select
Money
Training
23. As a THIN member you have the opportunity to earn extra money for "follow-up" studies through THIN's Additional Information Services Department (AIS). Payments start from £30 per patient request.?
Are you interested in finding out more?
Please select
Yes
No
If "Yes" please leave contact details:
Name
Position
Telephone
Email
Thank you for your time!
The Health Improvement Network, 1 Canal Side Studios, 8-14 St Pancras Way, London NW1 0QG
Tel: +44 (0)20 7554 0663 E-mail:
info@thin-uk.com