Library membership form

All NHS staff and students on placement at Gloucestershire Hospitals NHS Foundation Trust can join our library. Please read our terms and conditions, and privacy policy before you complete this form, at gloshospitals.nhs.uk/library-and-knowledge-service/join-the-library/

Are you a member of staff or a student? *

First name *

Surname *

Home address and postcode *

Job title *

Department *

Professional group *

Organisation *

Email address *

Contact number or bleep *

Which hospital site are you mainly based at? *

Contract end date (if applicable)

If you selected 'other' for any answer, please provide details

Title of course, including name of university or college

Students on placement only

If you have a long term condition or disability, is there anything we can do to make your library experience easier?

I wish to be set up with a GHNHSFT OpenAthens account (a username and password which gives access to online resources)

I agree

Please confirm you have read and agree to the terms and conditions on the library and knowledge homepage *

I have read and agree to the T&Cs

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Library membership form