Buying Accurx

Buying Accurx
The Order Form below sets out the details for your contract with Accurx. You are able to generate a draft form for your internal use or submit the Order Form to submit an order. If you have any questions, do not hesitate to contact us at partnerships@accurx.com.

If the number of FTEs within your organisation is greater than 300, please contact partnerships@accurx.com instead of completing this form.

Order Form
Your Details (Key Contact)
Name*

First NameLast Name
Email*
Role
Finance Details
Finance Contact Name*

First NameLast Name
Finance Contact Email*
example@nhs.com
IT Contact
Is your IT Contact the same as your Key Contact?*
IT Contact Name*

First NameLast Name
Email*
example@nhs.com
Data Protection Officer (DPO) (if known)
DPO Name

First NameLast Name
DPO Email
example@nhs.com
Contracting Organisation's Details
Enter the ODS Code of the Contracting Organisation*
Find your ODS Code.
Name of Contracting Organisation*
Full Time Equivalents (FTEs)*
Please enter the number of Full Time Equivalents (FTEs) within your organisation (include all employees)
Account Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If your organisation uses EMIS or SystmOne, please share name and number of each clinical system that needs access to Accurx under this contract
Click here to see how to find your clinical system name and number

Accurx Modules & Toolkits

For Community Services
There are two packages available for purchase.

Packages are based on the size of your organisation (using Full Time Equivalents as a proxy). Please note the Annual Licence Fee does not include VAT and SMS Costs.

Select the bundle you would be interested in purchasing and the form will generate a price for you.

If the number of FTEs within your organisation is greater than 300, please contact partnerships@accurx.com instead of completing this form.
Select Your Bundle
Total FTEs for this Contract
Please select the bundle you would like to purchase:*

Bronze BundleSilver Bundle
Select Tier -1 Bronze
Select Tier 0 Bronze
Select Tier 1 Bronze
Price Tier -1 Bronze
Price Tier 0 Bronze
Price Tier 1 Bronze
Select Tier -1 Silver
Select Tier 0 Silver
Select Tier 1 Silver
Price Tier -1 Silver
Price Tier 0 Silver
Price Tier 1 Silver
TOTAL ANNUAL FEE
Licence fees for number of FTEs
TOTAL ANNUAL FEE + VAT*
*Excludes SMS Costs which will be invoiced separately and charged using the direct debit details provided. SMS Costs are calculated based on fragment usage, where a fragment is 160 characters of text and on average, one Accurx text is made up of 2.3 fragments. For Accurx orders covering a Patient population of less than 100,000, SMS Costs are payable for SMS Fragments sent the previous calendar month at 2.25p plus VAT per fragment (if paid by Direct Debit) or 2.35p plus VAT per fragment (if not paid by Direct Debit).
Contract Start Date*

DayMonthYear
This is the date from which you'll be charged Licence Fees and SMS Costs. Contracts run for 12 months from the Contract Start Date and will automatically renew annually unless terminated.
If you'd just like a quote at this stage, click "Save" to save your quote will be saved and come back to submit an order at a later date.

Direct Debit Details

Your Direct Debit will be set up once the Order Form has been submitted. Licence Fees and SMS Costs will be collected by Direct Debit. Please complete this section with the instruction to your bank or building society to pay by Direct Debit.
Customer Name or Company Name*
Name of Account Holder*

First NameLast Name
Bank/Building Society Account Number*
Branch Sort Code (old)*
Branch Sort Code*
Bank/Building Society Account Number*
Full Address of Bank*

Street Address

Street Address Line 2

CityCounty

Post Code
Signature*

Clear
Date

DayMonthYear
Date
Licence Fee payment terms*
Please specify if your Trust would like to pay Licence Fees annually or monthly. Please note that SMS Costs are charged monthly in arrears.
The Direct Debit Guarantee
- This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits
- If there are any changes to the amount, date or frequency of your Direct Debit GC re Accurx Ltd will notify you 3 working days in advance of your account being debited or as otherwise agreed. If you request GC re Accurx Ltd to collect a payment, confirmation of the amount and date will be given to you at the time of request
- If an errors is made in the payment of your Direct Debit, by GC re Accurx Ltd or your bank or building society, you are entitled to a full and immediate refund of the amount paid from your bank or building society.
- If you receive a refund you are not entitled to, you must pay it back when GC re Accurx Ltd asks you to.
- You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.

Minimum Capability Requirements
Please note that there are Minimum Specifications required for Accurx to work smoothly. These can be found here:

Requirements for desktop computers

Requirements for web browsers

Requirements for internet speed/connectivity

By submitting the Order Form you confirm that you and any other practices covered by this contract have devices/computers that meet these Minimum Specifications.
Order Now
Order Now to submit your Order Form to Accurx. Once it has been submitted and you accept our Terms and Conditions below, you'll be given access to the Accurx Products you've ordered on your preferred Switch-on Date.

By providing payment details and completing/submitting this Order Form, you confirm that you are an authorised signatory and are able to agree these terms on behalf of the purchaser under this contract.

If you have any questions before submitting, do not hesitate to contact us using our live chat on our website.
Please submit any comments or questions here.
Should be Empty:

Order Form

Your Details (Key Contact)

Finance Details

IT Contact

Data Protection Officer (DPO) (if known)

Contracting Organisation's Details

Accurx Modules & Toolkits

Select Your Bundle

Direct Debit Details

Minimum Capability Requirements

Order Now