Healthcare professional contact form

PLEASE READ CAREFULLY BEFORE FILLING IN THE FORM BELOW.

We are always happy to provide a complimentary Nitty Gritty Comb and literature for evaluation purposes, but only to healthcare professionals working with children and families affected by head lice.

This is because the NHS employ 1.7m people and we are sorry but we are unable to provide samples to NHS employees who do not work directly with people affected by head lice.

Please note that we can provide you with one sample comb (unless you contact us directly) with a MAXIMUM OF 3 REQUESTS PER HEALTH/MEDICAL CENTRE. Please do not send multiple requests for more than 3 staff members as we will be unable to fulfil the requests.

In order to make sure that they are getting to the right people (GP's, practice and school nurses, health visitors, pharmacists etc) who will be using them in their professional capacity, we need

(i) the request to come from an NHS (or equivalent) email address

(ii) the delivery address MUST be your NHS/Private Practice, Health Centre, hospital address or professional establishment where you work and MUST include your job title AND the department that you work in.

REGISTERED CHILDMINDERS. PLEASE READ CAREFULLY
Reluctantly we are no longer available to give free Nitty Gritty Combs to childminders.

Every month we used to allocate a quota of complimentary Nitty Gritty Combs for registered childminders. Unfortunately we have become victims of our own success - it was posted on so many childminder forums that the sheer volume of childminders asking for complimentary combs has just become too many.

We are very sorry to disappoint you, but we are a small company (3 mums) and much as we’d like to give one to every childminder in the country, it would put us out of business!

However the GOOD NEWS is that we are able to offer childminders a special discount on the Nitty Gritty Comb. To get a whopping £5 discount just enter the code CM0610 plus the first 2 letters of your OFSTED registration (or Care Commission) with no spaces (eg: CM0610AZ) in the Discount Code box on the Basket page and click Update. Please also put your FULL Ofsted (or Care Commission) Registration number in the ‘How did you find us’ box on the Checkout page.

And we’ve got even more GOOD NEWS - you can still get the Nitty Gritty Comb free on NHS prescription (free for children Under 16’s). You can read how to get the comb on prescription at the following link and you can even print out a letter to take to your GP.

http://www.nittygritty.co.uk/site/howtogetaprescription.asp

WE CAN ONLY SUPPLY SAMPLE NITTY GRITTY COMBS TO HEALTHCARE AND EDUCATION PROFESSIONALS WITHIN THE UK

REMEMBER, MAXIMUM OF 3 COMB REQUESTS FOR STAFF MEMBERS PER HEALTH/MEDICAL CENTRE

Please complete the form below

* Mandatory fields

Name*
Job Title*
Department*
Address 1*
Address 2*
Address 3
Address 4
Postcode*
Email*
Contact phone number
Would you like a sample Nitty Gritty Comb?*	Please select Yes No
You can download and print this A5 information leaflet. But if you would prefer us to send you some by post, please state how many you would like.
Are you interested in any Healthcare Initiative Discount Schemes we are currently running?*	Please select Yes No
Where did you hear about Nitty Gritty?
Reason for requesting a Nitty Gritty Comb and any other Comments*
	Type both words separated by a space below: