NPPG Membership Form 2024

Membership Form for 1st Jan 2024 to 31st December 2024

Details for paying Standing Order or PayPal can be found at the following link..

Click here to open a printable copy of payment options

As part of your membership you can register on the NPPG Message Board - www.networks.nhs.uk/nhs-networks/nppg-neonatal-and-paediatric-pharmacists-group .

Membership enquiries - Tel no: 020 3725 5840 admin@nppg.org.uk

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* 1. Type of application

I am renewing my membership

I am a new member

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* 2. Name

Title

Surname

Forename

Member number (if renewing)

If new where did you hear about NPPG?

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* 3. Ethnicity (options based on 2021 Census options)

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* 4. Preferred contact address and details

Institute

Department

Street

Town

County

Post Code

Country

Telephone number

Email address - use same one on message board

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* 5. Description

Pharmacist

Technician

Other (please specify)

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* 6. band / Grade

Lecturer

Other (please specify)

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* 7. Main area of practice

Paediatric hospital

Maternity Hospital

Paediatric / Neonatal unit within DGH

Paediatric / Neonatal unit within Teaching hospital

University

Community Pharmacy

GP Practice

Trust / Health board management office

Industry

Home

Other (please specify)

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* 8. Are you a member of the Royal Pharmaceutical Society of Great Britain

Yes

Not applicable

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* 9. Please indicate any engagement with RPS development programme

I am currently building my Faculty portfolio

I am working towards Post-registration Foundation credentialing

I am credentialed at Post-registration Foundation level

I am an Advanced Stage I Faculty member (MFRPSI)

I am an Advanced Stage II Faculty member (MFRPSII)

I am a Faculty Fellow (FFRPS)

I am working towards Core Advanced credentialing

I am working towards Consultant credentialing

I am a credentialed Consultant Pharmacist

I am working in an approved Consultant Pharmacist post

None of the above

Not applicable (not a member)

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* 10. Independent Prescribing (IP)

I have not started any IP training

I am in the process of completing an IP course

I am an IP and use this on a regular basis

I am an IP but do not use it routinely

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* 11. Data sharing

Tick to receive the newsletter / other mailings via the NPPG website only

Tick for NPPG members to have access to your details

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* 12. Subgroup membership (no extra cost)

I wish to become a member of the Paediatric Oncology Pharmacists (POP) group

I wish to become a member of the Paediatric Critical Care Pharmacists (PCC) Group

I wish to become a member of the Neonatal Intensive Care Group

I wish to become a member of the Paediatric and Neonatal Gastroenterology (PANG) Group

I wish to become a member of the Respiratory Interest Group (RIG)

I wish to become a member of the Rheumatology sub group

I wish to become a member of the Pharmacy Technician sub group

I wish to become a member of the Cardiac Sub Group

I wish to become a member of the Metabolic subgroup

I wish to become a member of the District General Hospital subgroup (DGH)

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* 13. NPPG has set up regional groups in Great Britain to help members interact locally. Please select the regional group you feels best meets your geographical needs (you can choose more than one)

South West

South Central

South East

London

East Anglia

East Midlands

West Midlands

Wales

North West

North East

Scotland (SNAPP)

Northern Ireland

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* 14. NPPG is frequently asked to respond to consultations and scoping events for guideline development, particularly in relation to NICE Guidance. If you would be interested in hearing about opportunities to be considered for this work then please tick

Yes

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* 15. Please indicate below by ticking any appropriate boxes your interests and personal specialities. This data may be used by the group to put people in touch with you if they need advice or if they are doing a particular study. (None of us know everything so please don’t be shy)

	Interested	Specialist	Willing to respond to consultations on the subject	Happy to be approached for E&T projects
Neonates	Neonates Interested	Neonates Specialist	Neonates Willing to respond to consultations on the subject	Neonates Happy to be approached for E&T projects
Paediatrics	Paediatrics Interested	Paediatrics Specialist	Paediatrics Willing to respond to consultations on the subject	Paediatrics Happy to be approached for E&T projects
Paediatric Oncology / Malignant Haematology	Paediatric Oncology / Malignant Haematology Interested	Paediatric Oncology / Malignant Haematology Specialist	Paediatric Oncology / Malignant Haematology Willing to respond to consultations on the subject	Paediatric Oncology / Malignant Haematology Happy to be approached for E&T projects
Paediatric non-malignant Haematology	Paediatric non-malignant Haematology Interested	Paediatric non-malignant Haematology Specialist	Paediatric non-malignant Haematology Willing to respond to consultations on the subject	Paediatric non-malignant Haematology Happy to be approached for E&T projects
Drugs In Pregnancy and Lactation	Drugs In Pregnancy and Lactation Interested	Drugs In Pregnancy and Lactation Specialist	Drugs In Pregnancy and Lactation Willing to respond to consultations on the subject	Drugs In Pregnancy and Lactation Happy to be approached for E&T projects
Haematology	Haematology Interested	Haematology Specialist	Haematology Willing to respond to consultations on the subject	Haematology Happy to be approached for E&T projects
Immunology	Immunology Interested	Immunology Specialist	Immunology Willing to respond to consultations on the subject	Immunology Happy to be approached for E&T projects
Metabolic	Metabolic Interested	Metabolic Specialist	Metabolic Willing to respond to consultations on the subject	Metabolic Happy to be approached for E&T projects
Off Label/orphan Drug Use	Off Label/orphan Drug Use Interested	Off Label/orphan Drug Use Specialist	Off Label/orphan Drug Use Willing to respond to consultations on the subject	Off Label/orphan Drug Use Happy to be approached for E&T projects
Paediatric/Neonatal Nutrition	Paediatric/Neonatal Nutrition Interested	Paediatric/Neonatal Nutrition Specialist	Paediatric/Neonatal Nutrition Willing to respond to consultations on the subject	Paediatric/Neonatal Nutrition Happy to be approached for E&T projects
Palliative Care	Palliative Care Interested	Palliative Care Specialist	Palliative Care Willing to respond to consultations on the subject	Palliative Care Happy to be approached for E&T projects
Pain Control	Pain Control Interested	Pain Control Specialist	Pain Control Willing to respond to consultations on the subject	Pain Control Happy to be approached for E&T projects
Paediatric Critical Care	Paediatric Critical Care Interested	Paediatric Critical Care Specialist	Paediatric Critical Care Willing to respond to consultations on the subject	Paediatric Critical Care Happy to be approached for E&T projects
Paediatric Renal	Paediatric Renal Interested	Paediatric Renal Specialist	Paediatric Renal Willing to respond to consultations on the subject	Paediatric Renal Happy to be approached for E&T projects
Paediatric Cardiology	Paediatric Cardiology Interested	Paediatric Cardiology Specialist	Paediatric Cardiology Willing to respond to consultations on the subject	Paediatric Cardiology Happy to be approached for E&T projects
Paediatric Neurology	Paediatric Neurology Interested	Paediatric Neurology Specialist	Paediatric Neurology Willing to respond to consultations on the subject	Paediatric Neurology Happy to be approached for E&T projects
Paediatric Liver	Paediatric Liver Interested	Paediatric Liver Specialist	Paediatric Liver Willing to respond to consultations on the subject	Paediatric Liver Happy to be approached for E&T projects
Paediatric Gastroenterology	Paediatric Gastroenterology Interested	Paediatric Gastroenterology Specialist	Paediatric Gastroenterology Willing to respond to consultations on the subject	Paediatric Gastroenterology Happy to be approached for E&T projects
Paediatric Dermatology	Paediatric Dermatology Interested	Paediatric Dermatology Specialist	Paediatric Dermatology Willing to respond to consultations on the subject	Paediatric Dermatology Happy to be approached for E&T projects
Paediatric Endocrinology	Paediatric Endocrinology Interested	Paediatric Endocrinology Specialist	Paediatric Endocrinology Willing to respond to consultations on the subject	Paediatric Endocrinology Happy to be approached for E&T projects
Antibiotics/Paediatric Infectious Diseases	Antibiotics/Paediatric Infectious Diseases Interested	Antibiotics/Paediatric Infectious Diseases Specialist	Antibiotics/Paediatric Infectious Diseases Willing to respond to consultations on the subject	Antibiotics/Paediatric Infectious Diseases Happy to be approached for E&T projects
HIV / Aids	HIV / Aids Interested	HIV / Aids Specialist	HIV / Aids Willing to respond to consultations on the subject	HIV / Aids Happy to be approached for E&T projects
Formulations	Formulations Interested	Formulations Specialist	Formulations Willing to respond to consultations on the subject	Formulations Happy to be approached for E&T projects
Cystic Fibrosis	Cystic Fibrosis Interested	Cystic Fibrosis Specialist	Cystic Fibrosis Willing to respond to consultations on the subject	Cystic Fibrosis Happy to be approached for E&T projects
Respiratory	Respiratory Interested	Respiratory Specialist	Respiratory Willing to respond to consultations on the subject	Respiratory Happy to be approached for E&T projects
Mental Health	Mental Health Interested	Mental Health Specialist	Mental Health Willing to respond to consultations on the subject	Mental Health Happy to be approached for E&T projects
Genomics	Genomics Interested	Genomics Specialist	Genomics Willing to respond to consultations on the subject	Genomics Happy to be approached for E&T projects

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* 16. Payment options

I have set up a Standing Order for the NPPG account at the HSBC. Account number 21380273. Sort Code 40-29-26

PayPal tick box and click here (Enter relevant amount on the page that opens)

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* 17. Payment amount

£50

£25 - for Technicians only

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* 18. Tick this box to signify that you will comply with NPPG policies - details here - the link also includes details of how NPPG use your data under GDPR

Yes