Form - Testing - SCW Child Health Information Service (CHIS)

Request for CarePlus User Account

Please note that this form is intended for users in regions where SCW manages a CHIS Service. For areas not under SCW management, access to the Child Health System should be requested from the respective CHIS department for that region.

SCW Contracts:

Cheshire and Merseyside: East Cheshire, Halton, Knowsley, Liverpool, Sefton St Helens, Warrington, West Cheshire & Wirral

Greater Manchester: Bolton, Bury, Manchester, Oldham, Rochdale, Salford, Stockport, Tameside, Trafford & Wigan

South Central, West & Surrey: Bath & Noth East Sommerset, Berkshire, Bristol, Buckinghamshire, Cornwall, Exeter, Gloucestershire, North Devon, Oxford, Plymouth & Torbay, Somerset, Surrey, Swindon, Wiltshire

System Access Requirements

SCW Contracts:

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#Please note that users outside of the CHIS departments will be granted Read Only access. If additional access is required, please include a note in the comments field at the bottom of this form.

Staff Details

Are you completing this form on behalf of someone else?(*)

Yes

Please select

Name of Person completing this form:

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Job Title of person completing this form:

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Name:

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Email Address:

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Job Title:

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Organisation:

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Team/Service:

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Comments:

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Employee Declaration

I agree to adhere to the following principles of acceptable usage of the Child Health Information System:

Users should only access data on individuals where there is a business (clinical or administrative) need for them to do so. Accessing information on individuals where the user does not have a business need to do so or accessing information on individuals that are known to the user is prohibited. Any inappropriate access identified will result in investigation and possible disciplinary action.
Users must not allow any other individual to log on to the system under their logon credentials. To that extent all users are required to keep their individual passwords secret.
Users agree not to maliciously record or alter information within any part of the system. Any suspected malicious activity will be investigated and if necessary disciplinary action will be taken.
Users agree to inform the relevant system manager should their requirements for access to the system change, regardless of whether their requirement increases, decreases or is no longer necessary.
Users accept that their activity on the system is monitored.

I agree to the above terms of use

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Line Manager Authorisation

I would like to request access to the CarePlus Child Health Information System for the above-named member of staff for whom I am responsible. I am aware of the policies on system use including the Data Protection Act and the Acceptable Use Policy and will ensure that these policies are adhered to by the employee. I am also aware that any breach of policy will result in access being revoked for that employee and possible disciplinary action being taken by the employing body.

Name:

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Email Address:

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Date:

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Thank you

Testing Site

Request for CarePlus User Account