Londonwide LMCs’ Buying Group - registration and consent form

I would like to our practice, as detailed below, to be able to access the services provided by the Londonwide LMCs’ Buying Group.

I understand that Londonwide LMCs is acting as an introducer for Buying Group providers and the information I enter below will be shared with them.

Please note that this will enable Buying Group providers to contact you about their services in relation to the Londonwide LMCs' Buying Group and identify your practice as eligible for the discounts negotiated for Londonwide LMCs' Buying Group members.

Londonwide LMCs will use the details provided to email you with details of Buying Group developments and information about additional providers that may join the Buying Group in the future.

Question Title

* 1. LMC area (please choose an area from the list).

Question Title

* 2. Practice code

Question Title

* 3. Practice name

Question Title

* 4. Practice address

Question Title

* 5. Practice post code

Question Title

* 6. Practice telephone number

Question Title

* 7. Contact name at the practice

Question Title

* 8. Contact email address

Question Title

* 9. Please let us know which Buying Group provider(s) you are happy to be contacted by.

I consent for the information provided above to be shared with MidMeds so they can contact me about buying group services.

I consent for the information provided above to be shared with MIAB so they can contact me about buying group services.

I consent for the information provided above to be shared with Practice Index so they can contact me about buying group services.

I consent for the information provided above to be shared with all three Buying Group providers and any future providers that join the Londoniwde LMCs' Buying Group.

If at any time you wish to withdraw your consent or no longer wish to be contacted by any Londonwide LMCs' Buying Group supplier, please email buyinggroup@lmc.org.uk and we will record this decision and advise Londonwide LMCs' Buying Group suppliers accordingly.