Auto iceQR registration version 8

Part (1) - These details will not show when the QR code is scanned

Full Name*

First NameLast Name

E-mail*

Confirmation Email

Please enter the 5 digit serial number that you wish to register.

To register another helmet sticker with different details when scanned, please submit this form when finished and register again.

Serial number as it appears on your iceQR product*

Part (2) What information do you want displayed when your QR code is scanned?

Please read data security notice

Next of kin

First NameLast Name

Next of kin contact details

Area CodePhone Number

National health service numbers are 10 digits displayed as 000 000 0000

Please DO NOT enter your National Insurance (Ni) number that starts with 2 letters.

If you do not have your NHS number, please enter at a later date after you complete your registration on the support page.

How to obtain your NHS number HERE

I have my NHS numberI will complete my NHS number later

National health service number

Any other details you wish to include. E.g. any relevant medical history, blood type, allergies, organ donor status

User information:-

What message would you like a first responder to give to your next of kin in the event of an emergency?

Message to next of kin:-

Please upload any photos or documents that you would like to such as an image to identify you and/or insurance documents. Maximum 10 files, 4mb per file, , jpeg or png,

Upload a File

Region*

Notes:

Registrations take 48 hours Monday-Friday, please scan your code after this time to check your details are correct.
If you do not have all the information you wish to include, please save your details and complete later.

Storage of your data is free for 12 months then £1.50 per year.

To finish your registration, please complete auto renewal for next year.

We will email with any details necessary for account administration purposes. We may also email you iceQR user safety information updates, if you do not wish to receive these updates please turn safety notifications off, you can change your settings at any time.

Privacy policy.

Form AUTO030724