We found some errors in the details you provided. Please check below for details. Order smartcard readers Form submitted successfully Thank you for submitting this form. Region and organisation Region * South London Midlands and East North National Organisation type * Commissioning Support Unit Clinical Commissioning Group Acute Trust Ambulance Trust Mental Health Trust Community Trust Non-NHS RA Service Provider Other Organisation name * ODS code * Delivery address Please ensure your full address is provided. RA manager name * Telephone number * Email * Room * Department * Address line 1 * Address line 2 Town or city * County * Postcode * Delivery instructions Order details USB and Proximity readers Please specify the number of individual readers required below. Card reader USB – number of individual readers required if fewer than 50 NHS organisations only. Card reader USB – number of boxes of readers required (50 per box) NHS organisations only. Proximity ‘clean’ card reader – number of individual readers required (maximum 5 per order) Proximity ‘clean’ readers (for use ONLY in clean areas with clean keyboards, such as operating theatres). NHS organisations only. Reason for your order What's the business justification for your order? * Deployment Business as usual (such as new starters) Junior doctor intake Other Please expand on the the business justification selected. Approval is subject to review. * This may include deployment, business as usual, new starters or another reason. Any personal information you give to us will be processed in accordance with the UK Data Protection Act 1998. We will use the information to process your request and to provide any further relevant information or services you have requested. It will also be used to support our service development activities.