BSDS Mohs Surgeon Logbook information request

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We need some basic information to use to set up your login details, and those for anyone in your unit who will need to enter data.

Every surgeon (both primary and assisting i.e. Mohs surgeons and attached trainees) needs an individual account, and also anyone entering cases or results data (e.g. a Biomedical scientist ('Mohs tech’), secretary, administrator)

Email *

Prefix (Dr/Mr/Mrs/Ms/Miss *

First name *

Surname *

Grade *

Consultant

Fellow

Specialty Registrar

Specialty Doctor

Specialist Nurse

BMS

Secretary

General Practitioner

Core Trainee

Medical Student

Specialty (if not Dermatology please state which in comments box below) *

Dermatology

Other

GMC / NMC number (if not applicable write n/a) *

Main work email address *

Are you the lead contact for your unit? *

Every unit needs one lead Consultant contact for authorising new users/user access changes/unit reports. This is not onerous.

Yes

Unit name (*This will usually be the name of your unit or MDT. Examples already set up include: Bristol, Newcastle, Cardiff. For London it would be your MDT or institution.) *

Anything else you would like to add or ask? *

Submit

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