Greater Manchester Healthy Living Pharmacy Pharmacy Information Survey Question Title * 1. Contact Information GPhC registered first name: GPhC registered surname: Pharmacy Name: Pharmacy Address: Post Code: ODS code: GPhC number: Email Address: Contact Number: Question Title * 2. What is your CCG locality area? Ashton, Leigh & Wigan Bolton Bury Central Manchester Glossop Heywood, Middleton and Rochdale North Manchester Oldham Salford South Manchester Stockport Tameside Trafford Question Title * 3. Are you a HLP pharmacy? Yes No Question Title * 4. If no, would you be interested in becoming an HLP pharmacy? Yes No Question Title * 5. Have you received HLP accreditation? Yes No Question Title * 6. Have you got a HLP Champion? If yes please provide details: Full Name Role Do they still work at the pharmacy? Question Title * 7. Has your pharmacist attended leadership training? If yes please provide details: Full Name When did they receive this training? Do they still work at the pharmacy? Question Title * 8. Have you got a pharmacist or pharmacy member trained as a Dementia friend? If yes please provide details: Full Name Role Do they still work at the Pharmacy? Done