Combined endpoint and service registration request

Section 1: Contact details

Name *

Organisation

Telephone

Email *

Section 2: What do you want to do?

Select one answer *

• Create/renew a certificate only
• Create an endpoint (including certificate)
• Other endpoint related activity

Please complete all required sections below with requested details.

If you wish to make any amendments to an existing endpoint you'll need EPR admin. Please see relevant environment page.

Section 3: Path to Live environments

Select one environment. Complete a separate form for each environment you need to connect to.

Environment Select an option Integration Development Deployment Training

Environments are restricted by usage and have entry criteria - check the website for more details.

Fully Qualified Domain Name (FQDN) *

You must have an FQDN to generate an endpoint

Additional comments/notes

Provide any further information you think will be useful to support your request

Section 4: Request a new certificate

Certificate Signing Request (CSR)

Generate the CSR with only the common name field populated which must match the FQDN - all other fields can remain blank. The email field MUST be blank. Please note FQDNs MUST be in the .nhs.uk domain as we can only issue certificates in this domain.

Existing party key

If you do not know your Party Key, or don’t have one, we can create the certificate against a dummy organisation for you. Please note, renewing a certificate will automatically revoke any existing certificate.

Section 3: Path to Live environments

Select one environment. Complete a separate form for each environment you need to connect to.

Environment Select an option Integration Development Deployment Training

Environments are restricted by usage and have entry criteria - check the website for more details.

Fully Qualified Domain Name (FQDN) *

You must provide an FQDN to generate an endpoint or certificate.

Section 4: Request a new certificate

Certificate Signing Request (CSR)

Generate the CSR with only the common name field populated which must match the FQDN - all other fields can remain blank. The email field MUST be blank. Please note FQDNs MUST be in the .nhs.uk domain as we can only issue certificates in this domain.

Additional comments/notes

Provide any further information you think will be useful to support your request

Section 5: Create new endpoint

This section should be used to create new MHS or CMA endpoints

Tell us which type of endpoint needs creating

If you do not specify, or are unsure, we will create a CMA endpoint

• CMA endpoint

A single party key and corresponding ASID will be created

• MHS endpoint

An MHS only party key will be generated - additional ASIDs for this party key must be specified in Section 6 of this form

Recipient ODS code

If you do not know your ODS code please email: [email protected]

Recipient ODS organisation name

Manufacurer/Deployer's ODS code

Manufacturer product

Manufacturer product version

Section 6: Additional ASIDs

If you chose the MHS Only party key option in section 5, please specify the ODS code and product information for each ASID required.

Recipient ODS code

If you do not know your ODS code, please email: [email protected]

Recipient ODS organisation name

Manufacturer/Deployer's ODS

Manufacturer product

Manufacturer product version

Associated Party Key

Only required if you are an adding an additional ASIDs to an existing MHS Party key. New Endpoints ASIDs will automatically be added to the MHS Party Key created in section 5.

Section 7: Party Keys and MHS URL Bindings

Indicate a binding URL for each message type or choose one for all messages

Provide up to 6 sets of services and binding URLs

If you need to provide further entries please email: [email protected]

Service

Binding URL

Service

Binding URL

Service

Binding URL

Service

Binding URL

Service

Binding URL

Service

Binding URL

Section 8: Other information

Please provide details of your requirement