Get Consultant Psychiatrist Data Form - Ztas

Filling out the Consultant Psychiatrist Data Form - ZTAS is essential for registering or updating details related to the prescribing of Zaponex. This guide provides clear, step-by-step instructions to assist you in completing the form accurately and efficiently.

Follow the steps to complete your form online with ease.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Begin by entering your GMC number in the appropriate field labeled 'GMC number.' This number is crucial for your registration.
3. Next, choose your title from the options provided, either 'Prof' or 'Dr.' Ensure you select the title that best represents your professional identity.
4. Fill in your full name in the designated area. Make sure to write your name clearly and in block letters.
5. Provide your job title in the specified field. This should reflect your current position within the medical field.
6. Input your emergency telephone number along with your contact number for patients. Both numbers are vital for communication purposes.
7. Enter your fax number to ensure the ZTAS can communicate with you as necessary.
8. Provide your email address. This will be used for correspondence regarding your application.
9. Indicate the hospital associated with your practice by filling out the corresponding section.
10. Complete the contact address section. Include your private practice details, medical facility name, ward, address, town/city, county, and postcode.
11. Read the statement of intent carefully. When you are ready, sign and date the form to confirm your commitment to adhering to the Zaponex SmPC and the ZTAS Manual.
12. After reviewing the form for accuracy, you can either save changes, download a copy, print it out, or share it as necessary.

Complete your Consultant Psychiatrist Data Form - ZTAS online today to ensure a smooth registration process.