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If you are interested in using the eclipse system or you would like more information. Please complete the short form below and a member of our team will be in touch as soon as possible.

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Name:		Please tell us your name.
CCG:	NOT SET NHS Airedale, Wharfedale And Craven CCG NHS Ashford CCG NHS Barking And Dagenham CCG NHS Barnsley CCG NHS Basildon And Brentwood CCG NHS Bassetlaw CCG NHS Bath And North East Somerset CCG NHS BEDFORDSHIRE, LUTON AND MILTON KEYNES INTEGRATED CARE BOARD NHS Berkshire West CCG NHS Bexley CCG NHS Birmingham Crosscity CCG NHS Birmingham South And Central CCG NHS Blackburn With Darwen CCG NHS Blackpool CCG NHS Bolton CCG NHS Bournemouth And Poole Teaching CCG NHS Bracknell And Ascot CCG NHS Bradford City CCG NHS Bradford Districts CCG NHS Brent Teaching CCG NHS Brighton And Hove CCG NHS Bristol, North Somerset and South Gloucestershire CCG NHS Bromley CCG NHS Buckinghamshire CCG NHS Bury CCG NHS Calderdale CCG NHS Cambridgeshire and Peterborough ICB NHS Cannock Chase CCG NHS Canterbury And Coastal CCG NHS Castle Point and Rochford CCG NHS Central & Eastern Cheshire Mmt CCG NHS CENTRAL LONDON (WESTMINSTER) CCG NHS Central Manchester CCG NHS Chorley And South Ribble CCG NHS City And Hackney CCG NHS Coastal West Sussex CCG NHS CORNWALL AND THE ISLES OF SCILLY INTEGRATED CARE BOARD NHS Coventry And Rugby CCG NHS Crawley CCG NHS Croydon CCG NHS Darlington CCG NHS Dartford, Gravesham And Swanley CCG NHS Derby and Derbyshire CCG NHS Doncaster CCG NHS Dorset CCG NHS Dudley CCG NHS Durham Dales, Easington And Sedgefield CCG NHS Ealing CCG NHS East and North Hertfordshire CCG NHS East Kent NHS East Lancashire CCG NHS East Leicestershire And Rutland CCG NHS East Riding Of Yorkshire CCG NHS East Staffordshire CCG NHS East Surrey CCG NHS Eastbourne, Hailsham And Seaford CCG NHS Fareham And Gosport CCG NHS Fylde & Wyre CCG NHS Gloucestershire CCG NHS Great Yarmouth And Waveney CCG NHS Greater Huddersfield CCG NHS Greater Preston CCG NHS Greenwich CCG NHS Guildford And Waverley CCG NHS Halton CCG NHS Hambleton, Richmondshire And Whitby CCG NHS Hammersmith And Fulham CCG NHS Harrogate And Rural District CCG NHS Harrow CCG NHS Hartlepool CCG NHS Hastings And Rother CCG NHS Havering CCG NHS Herefordshire CCG NHS Herts Valleys CCG NHS Heywood, Middleton And Rochdale CCG NHS High Weald Lewes Havens CCG NHS Hillingdon CCG NHS Horsham And Mid Sussex CCG NHS Hounslow CCG NHS Hull CCG NHS Ipswich And East Suffolk CCG NHS Isle Of Wight CCG NHS Kingston CCG NHS Knowsley CCG NHS Lambeth CCG NHS Leeds North CCG NHS Leeds South And East CCG NHS Leeds West CCG NHS Leicester City CCG NHS Lewisham CCG NHS Lincolnshire East CCG NHS Lincolnshire West CCG NHS Liverpool CCG NHS Luton CCG NHS Mansfield And Ashfield CCG NHS Medway And Swale NHS Medway CCG NHS Merton CCG NHS Mid Essex CCG NHS Middlesbrough CCG NHS Milton Keynes CCG NHS Morecambe Bay CCG NHS Newark & Sherwood CCG NHS Newcastle Gateshead CCG NHS Newham CCG NHS North Central London CCG NHS North Cumbria CCG NHS North Durham CCG NHS North East Essex CCG NHS North East Hampshire And Farnham CCG NHS North East Lincolnshire CCG NHS North Hampshire CCG NHS North Kirklees CCG NHS North Lincolnshire CCG NHS North Manchester CCG NHS North Norfolk CCG NHS North Staffordshire CCG NHS North Tyneside CCG NHS North West Surrey CCG NHS NORTHAMPTONSHIRE CCG NHS Northern, Eastern And Western Devon CCG NHS Northumberland CCG NHS Norwich CCG NHS Nottingham City CCG NHS Nottingham North And East CCG NHS Nottingham West CCG NHS Oldham CCG NHS Oxfordshire CCG NHS Portsmouth CCG NHS Redbridge CCG NHS Redcar And Cleveland CCG NHS Richmond CCG NHS Rotherham CCG NHS Rushcliffe CCG NHS Salford CCG NHS Sandwell And West Birmingham CCG NHS Scarborough And Ryedale CCG NHS Sheffield CCG NHS Shropshire CCG NHS Slough CCG NHS Solihull CCG NHS Somerset CCG NHS South Devon And Torbay CCG NHS South East Staffordshire And Seisdon Peninsul CCG NHS South Eastern Hampshire CCG NHS South Kent Coast CCG NHS South Lincolnshire CCG NHS South Manchester CCG NHS South Norfolk CCG NHS South Sefton CCG NHS South Tyneside CCG NHS South Warwickshire CCG NHS South West Lincolnshire CCG NHS Southampton CCG NHS Southend CCG NHS Southport And Formby CCG NHS Southwark CCG NHS St Helens CCG NHS Stafford And Surrounds CCG NHS Stockport CCG NHS Stockton-on-tees Teaching CCG NHS Stoke On Trent CCG NHS Sunderland CCG NHS Surrey Downs CCG NHS Surrey Heath CCG NHS Sutton CCG NHS Swindon CCG NHS Tameside And Glossop CCG NHS Telford And Wrekin CCG NHS Thurrock CCG NHS Tower Hamlets CCG NHS Trafford CCG NHS Vale Of York CCG NHS Wakefield CCG NHS Walsall CCG NHS Waltham Forest CCG NHS Wandsworth CCG NHS Warrington CCG NHS Warwickshire North CCG NHS West Essex CCG NHS West Hampshire CCG NHS West Kent CCG NHS West Lancashire CCG NHS West Leicestershire CCG NHS WEST LONDON CCG NHS West Norfolk CCG NHS West Suffolk CCG NHS Western Cheshire CCG NHS Wigan Borough CCG NHS Wiltshire CCG NHS Windsor, Ascot And Maidenhead CCG NHS Wirral CCG NHS Wolverhampton CCG NHS Worcestershire CCGs	Please select your CCG from the drop down list. If your CCG is not list please contact us on enquiries@eclipsesolutions.org.
Job Title:		Please let us know your position within the CCG, eg. prescribing advisor.
Telephone:		This is optional (unless wishing to be contacted by telephone).
Email Address:		Please enter your email address.
Interest Level:	Yes please sign our CCG up. Definitely interested but need more information - reserve me a place. Might be interested but need more information. Thank you but not interested.
Preferred Method of Contact:	Email Telephone I do not wish to be contacted at this time  (Preferred time to be called)
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