CITATION SIGNON | QUIQSOLUTIONS

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Citation CQCPro Sign On

Please complete the form to sign-on to CQCPro. On receipt your new CQCPro system will be setup and training will be arranged.

We will process your order as quickly as possible and be back in touch very soon to finalise things.

Company

If this site setup is part of a group order, where there are additional sites, state the Groups name below.

Name of the Group or Organisation this site belongs to

How many sites in the Group

If a Group Order enter the Head Office Address

Address

Type of Service

Residential

Community Service

Dentist Practice

General Practitioner

Ambulance Service

Website Address

Title

Name

Position

Email

Phone

Is this an English or Scottish Provider?

English: CQC Pro

Scottish: Care Inspectorate Pro

CQC Location ID (English) or Service Number (Scottish)

CQC Provider ID (X-XXXXXXXXX)

Citation Account Contact Email

Enter the Contract Period (months)

Number of Users

upto 5

6 - 10

11 - 15

21 or more (may require additional information)

Survey Administrator Email

Thanks for the Order, ewe'll get right on it!

QUIQSOLUTIONS Ltd

Grove House

Prees

Shropshire

SY13 2DW

01948 841116

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