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TRFT Library & Knowledge Service:
Membership form for NHS Staff, Students & Contractors
Please complete all parts of this form and read our
terms and conditions
and
privacy statement
before clicking on 'Submit' to register with us. The declaration at the end of the form explains why we gather this information, how we hold it and how we will use it, in accordance with permissions granted by you.
1. About you
*
Indicates required field
Title (please select one)
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Dr
Mr
Mrs
Ms
Miss
Other
Name
*
First
Last
Work telephone/mobile/bleep:
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Your contract: please select:
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Permanent
Fixed term staff
On placement
If you are fixed term when does your contract end?
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If you are a student when does your placement end?
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Employer/Educational Establishment (i.e. your NHS Trust, Practice or University):
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Your job title:
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Name of your line manager:
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Site (where you are based e.g. Rotherham Hospital, Oak House, Barnsley General Practice):
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Department/Ward/Practice:
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University Registration Number (if student member):
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Email address: please provide your NHS, other work or university email account. New staff: if you're still waiting for your NHS email account please note this below:
*
New staff: if you're still waiting to get your NHS email account please enter 'Yes' below (we'll add details to your library account once it is available):
*
If you wish to receive emails relating to overdue items at a different email address please specify an alternative below:
*
2. Keep up to date: sign up for alerts
You've let us know above which email address we should use to contact you about overdue items. Please indicate below if you would like us to use this same email address to send you other alerts.
Library news: send me updates about library services: please select yes/no:
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Yes
No
New books: send me an email alert when you add new books in my specialty or relevant to my department: please select yes/no:
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Yes
No
Alerts and bulletins: send me regular evidence updates on my professional interests. Please tick select then complete the section below to tell us more about your interests: please select yes/no:
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Yes
No
Personalise your alerts & bulletins here:
I would like to receive personalised evidence updates to the email address provided above, on a (please select):
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Weekly basis
Monthly basis
Please tell us about your areas of professional interest:
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Which conditions/lifestyle factors are of interest? E.g. stroke, diabetes, alcohol misuse
*
Which settings are of interest? Please select:
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Acute
Community
General Practice
Other (please specify)
Other settings:
*
Which age groups are of interest? Please select:
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Neonates
Children & adolescents
Adults
Older people
3. How we use and store your data: please read, select and submit:
The information I have submitted is to the best of my knowledge accurate at the time of completion. I agree to inform the Library & Knowledge Service of any change of address or employment circumstances. I agree to abide by the
conditions of use
of the TRFT Library & Knowledge Service.
Your information is processed and held in accordance with data protection legislation. It will not be used for any purpose other than the administration of TRFT Library & Knowledge Service. Personal email addresses provided by you will only be used for the purposes outlined above.
The Library & Knowledge Service stores your information on an application called KnowledgeShare for internal library administration purposes. KnowledgeShare can also be used to share your contact details and professional interests with other NHS trusts that use it to promote knowledge sharing across the NHS: this will only be done with your permission. Please indicate your KnowledgeShare preferences below (you can change this at any time):
I agree to my data being held on KnowledgeShare:
*
Yes
No
For further information about KnowledgeShare and all other aspects of how we store and use your data please see our
Privacy Statement
.
Data submitted via our website:
I understand that the data I submit through this form will be held by the Library & Knowledge Service and by our web host Weebly in accordance with their respective privacy policies (https://www.trftlibraryknowledge.com/privacy-policy.html). Our Weebly service is hosted in the USA. Data submitted through our website is processed by Weebly, Inc. Whilst every care is taken by us to protect your data in the UK, the USA has its own Privacy Laws (Privacy Shield) and although some states are adopting GDPR regulations, this is not a statutory requirement. If you prefer not to submit your data in this way please contact the Library by phone or email; all our services can be accessed in this way.
I understand how my data is used in relation to Weebly: please select:
*
Yes
No
Submit
