Application for approval as a patient-class prescriber Data Supply Requirement (DSR):
If the prescriber works in more than one practice then the practice name and address details should be provided for each practice location for question. Do you work at more than one practice? Please list locations below .
In the case of unexpected leave or illness, a prescriber who can temporarily treat patients of the prescriber who is applying for approval should be nominated. Provide the street name of the contact address of the supporting prescriber in section 3 and 4 of the Application for approval as a Patient-class prescriber form.