Tell us about the product.

Complete the form and within one working day you will receive, in writing, a preliminary hazard list for your product and a fixed quote. Documents can be sent in reply to our first email and are held in confidence under the terms on the method page.

Organisation

Organisation name

Website

You are

The manufacturer of the product, DCB0129 An organisation deploying it, DCB0160

The product

Product name

What it does, in a paragraph

Intended use, in your own words

Who uses it, for which decision or task, and what happens next.

Deployment stage

NHS organisations using it now

Users and setting

Users

Clinicians Patients or the public Carers Administrative staff

Setting

Primary care Secondary care Community Mental health Social care Pharmacy Ambulance Other

Clinical function

What the product does clinically

Displays clinical information Supports a clinical decision Manages a workflow or referral Prescribing or medicines Communication with patients Remote monitoring Triage Documentation or ambient scribing Scheduling Other

Data and integration

Handles identifiable patient data

Yes No

Integrations

Hospital electronic patient record GP system NHS App or NHS login National services None Other

AI

AI in the product

If any AI: what it does, and whether model documentation exists

Releases and documentation

Release cadence

What exists already

Nothing yet A hazard log A clinical safety case report A clinical risk management plan A named officer in-house Documentation from a previous supplier or consultant

What is needed

Timing

A procurement or go-live date, if there is one.

Contact

Name

Role

Work email

I have read the privacy notice and understand that documents I send later are held in confidence.

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Novatib Ltd, registered in England and Wales, company number 14234369. contact@novatib.com

Enquiries are answered in writing within one working day. Privacy notice.