Enquiry Form

About you

First Name

Surname

Job Title

Telephone Number

Email Address

Do you prefer to communicate in Welsh or English?

About the organisation

Name

Type of Entity

Company Number

Address 1

Address 2

Address 3

Town

Unitary Authority Area

Country

Postcode

Main Telephone Number

Size of Business

Number of Employees

Organisation activity

Please provide a description of the organisation's products or services

Do the products or services fall under any regulatory framework?

Can compliance be demonstrated?

Please select an appropriate category for the organisation’s products or services

About the enquiry

Please outline how the organisation can help address the immediate needs of NHS Wales

We value your privacy

Our Privacy Notice sets out the ways we manage personal data.

The personal data provided by you to us may be used by us in the ways applicable data protection law allows, to contact you by post, electronic means (e-mail or text message) and/or by phone with information which we consider will be of legitimate interest.

I consent to personal data provided to you being used in this way

To help address the immediate need of the NHS the personal data you provide to us may also be shared with third parties such as NHS Wales and Welsh Government.

I consent to personal data provided to you being used in this way