Pre-Migration Questions Your Details Name(required) Organisation Name(required) Organisation Address Street Address(required) Address Line 2(required) City(required) Post Code(required) Telephone Number(required) Email(required) Practice Information Practice Manager's Name(required) Senior Partner(required) Number of Partners(required) What prompted the practice to move to SystmOne?(required) Privacy Officer (This is a nominated person responsible for monitoring the record viewing activity of their users. This person will be given the access rights on their Smartcard to manage alerts and audit record viewing activity)(required) Privacy Officer Staff Role (This will be the staff role as stated on the smartcard)(required) Main Contact(required) Second Contact(required) Practice ID / Site Reference (this will be your practice's national ID code. e.g. E12345)(required) Branch Sites Do you have a branch site?(required) Yes No If yes, what is the address of your branch site? Street Address Address Line 2 City Post Code If you have any additional branch sites, please write their addresses in the box below Additional Branch sites Migration Questions Current Capitation(required) How many staff members work at your site (that will be using SystmOne)?(required) Current System Type(required) Select one option EMIS Web Vision Microtest Other If other, please specify Scanning Software Select one option Docman 7 Docman 10 Integrated/None Other If other, please specify Do you provide any services other than GP or have any special registration types? (e.g walk-in patient, drug dependency…) (required) RBAC All end users need to have a role profile added to their Smart Cards by the RA agent. This will ensure that end users have the correct access rights to perform their role within SystmOne. It is essential that the access rights allocated to the Smart Card reflect the true rights required in SystmOne, otherwise end users will not be able to access the correct SystmOne functions. You need to make sure that you have your Smart cards set up correctly and they are ready to use for Go Live. If you have any problems with the set up you will need to speak to your RA manager. Are you an existing GP2GP enabled practice?(required) Yes No Are you an existing EPS2 enabled practice?(required) Yes No If yes, would you like EPS2 to be enabled for Go Live on SystmOne? Yes No Are you an existing Summary Care Record enabled practice?(required) Yes No VDI (Virtual Desktop Infrastructure) allows you to access SystmOne on a PC that doesn't have it installed. Do you wish to be enabled for VDI?(required) Yes No If yes, you must send a request to our VDI mailbox (VDI.enquiries@tpp-uk.com or VDI.application@tpp-uk.com) in order for this to be setup. Please tick this box to confirm you have sent a request. Do you want to be enabled for sharing prior to Go Live?(required) Yes No Do you plan to use the Airmid app for your patients once Live with SystmOne?(required) Yes No Potential Go Live Date(required) Submit Form Δ