UK NPIS 0344 892 0111
Ireland NPIC (01) 809 2566
mail@toxbase.org
  
 
A service commissioned by
Public Health England (PHE)
on behalf of the UK Health Departments
Application for TOXBASE online registration

TOXBASE online is freely available to UK NHS and NHS-affiliated departments, units and practices. Usernames are issued per unit/practice.

By completing this form you are requesting access to TOXBASE on the internet on behalf of your unit or practice.

You will become the Account Holder and will be asked to relay login details to your clinical colleagues. You will also be contacted to validate the unit/practice account (and distribute the new password to colleagues) on an annual basis.

Applications must be submitted by a senior clinician or nurse within the unit/practice, who will be asked to provide their professional registration number.

Access is available to commercial companies and other users, including those overseas, by annual subscription. If you do not work for the UK NHS please submit this form to receive a subscription quotation.

Note: this form applies only to TOXBASE online.

If you wish to register an individual account for the TOXBASE app you should download the app from the iOS or Android store and complete the registration form provided within the app. Further information on the TOXBASE app can be found here.  

PLEASE TELL US ABOUT THE UNIT/PRACTICE TO BE REGISTERED

Name of unit/practice:  
  * GP users please enter name of practice here
* Hospital users please enter name of department here
   
Full address:  
  * Hospital users please enter name of hospital here
   
 
   
Town:  
   
Postcode (or similar):  
   
Unit/practice tel:  
   
Unit/practice fax:
   
Is this unit/practice within the UK NHS?  
   
  PLEASE TELL US ABOUT YOURSELF:

Applications must be submitted by a senior clinician or nurse within the above unit/practice.

You will become the ACCOUNT HOLDER for your unit/practice.
   
Title:  
   
First name:  
   
Surname:  
   
Professional Registration Number:
e.g. GMC or PIN
 
   
Your job title:  
   
Your employer:  
Full name of your employer as per your payslip or contract of employment, e.g. "NHS Lothian"
   
Your tel:
(if different from above)
   
Your fax:
(if different from above)
   
Your e-mail:   
  You must provide your NHS or work-related e-mail address

As Account Holder you will be asked to validate your unit/practice account on an annual basis. Access to TOXBASE will be suspended if an accounts is not validated annually.
   
I confirm I am applying for TOXBASE registration on behalf of, and with the full authority of, the above named unit/practice and employer
I confirm that, should I no longer be responsible for the above unit/practice, I will provide contact details for a senior colleague who will become the new Account Holder
I confirm that TOXBASE use within the above unit/practice will be restricted to clinically trained staff
   
  PLEASE TELL US ABOUT THE HEAD OF THE ABOVE UNIT/PRACTICE
If you are the head of the above unit/practice, please provide contact details for a senior, secondary contact for your unit
   
Title:  
   
First name:  
   
Surname:  
   
Their job title:  
   
Their e-mail:   
  Please provide their NHS or work-related e-mail address
   
  PLEASE USE THIS BOX TO ENTER ANY FURTHER INFORMATION IN SUPPORT OF THIS APPLICATION
   
Where did you hear about TOXBASE?  
 
   
 
   
  On submission your application will be considered by NPIS Edinburgh, which is based within and operated through Lothian Health Board. NPIS Edinburgh is the NPIS unit responsible for administering and editing TOXBASE.

Applicants can expect to receive an email response within 1-2 working days.

If you experience problems sending this form please print and fax to 0131 242 1387