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Register Your Interest

If you are interested in using the eclipse system or you would like more information. Please complete the short form below and a member of our team will be in touch as soon as possible.

Your Details

Name: Please tell us your name.
CCG: Please select your CCG from the drop down list. If your CCG is not list please contact us on
Job Title: Please let us know your position within the CCG, eg. prescribing advisor.
Telephone: This is optional (unless wishing to be contacted by telephone).
Email Address: Please enter your email address.
Interest Level:

Preferred Method
of Contact:

 (Preferred time to be called)