NHS IP Address Information Request Form
- This document contains the set of templates to be used when submitting an IP assignment request to the Health and Social Care Information Centre
- This set of templates must be used by Health Entities when submitting a request to the NHS IP Registry.
- It may also be used by service providers to collect information from those managing the networks that will use the address space.
- Instructions for filling out the templates are found in the accompanying document "Supporting Notes for the NHS IP Address Space Request Form".
- Please enter telephone and fax numbers with no spaces eg 01179363636
- Please provide as much information as possible, as this will aid our decision-making and speed up your requests.
- Denotes mandatory field