IMMQAS External Quality Assessment

Registration Form

Please enter as much information as you can to help us validate who you are.
Each registration will be evaluated before access is given to the system.
Please enter the same email address twice, as this will be the main contact point and we need to ensure we can contact you.
If we need more information we will contact you via your email address.
If you are unsure about any registration details, please contact Dina Patel at eqacases@immqas.org.uk

UK NEQAS Participant Number

Full Name

Email Address

Confirm Email

Grade

Hospital Address

Address Line 2

Address Line 3

Town/City

Region

Country

Postcode

Primary Tel No.

Secondary Tel No.

Fax No.