About your organisation

Organisation name *

Organisation address *

Organisation Data Service (ODS) code

Contact name *

First name and last name

Email address *

Job title *

Contact telephone number

Please answer the following questions

Do you have access to e-RS FHIR API INT (Integration test environment) yet? Yes No

Do you know which e-RS FHIR API endpoints you will integrate with? Yes No

Please provide details of which endpoints you would like to use

What are your timescales/target dates for going live with an e-RS FHIR API integration?

Do you have any NHS customers ready to use the service?

Please read and confirm the following points

By submitting this form, I understand and agree to the following:

The company or organisation name will be registered as an NHS e-Referral Service (e-RS) FHIR API Partner and the organisational development status made available in the public domain in accordance with the Programme’s Transparency Policy Special Terms *

• I agree

I consent to receiving relevant emails from the NHS in the future. *

• I consent