ASPiH Accreditation registration form
Completion of this form confirms an individual or organisation’s intention to submit an application to be considered for an ASPiH accreditation award.
If you require any assistance with this form, please email
Are you completing this form as an individual, on behalf of an NHS trust simulation centre or an HEI facility?
NHS trust simulation centre
Name of employing organisation
Postcode of employing organisation
Job Title/ Role
Your role within your organisation
What is your current ASPiH membership status?
Named member on an Institutional membership
Neither, I am not currently a member of ASPiH
Which accreditation award are you intending to apply for?
Please give an estimate of the timescale for submission of your completed accreditation application
Within the next 3 months
Within 3 - 6 months
More than 6 months
How do you anticipate submitting your evidence?
In a zipped folder alongside the application form
On a shared drive, details below
Scanned and submitted alongside the application form
A combination of the above
Please provide details of the shared drive you will use and how access wil be provided to the ASPiH accreditation committee.
Name of contact
Name of the person to whom future correspondence should be addressed
Please provide any other information below that may be relevant to your accreditation registration
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