Mobile device form

Info

For BCIB mobile device requests, please contact BCICB Digital mobile phone support, bcicb.mobilephone@nhs.net.

Consent

By completing this form you consent to us storing the data *

Yes, I give permission to store and process my data

Requestor

Requestor name *

Requestor telephone number *

Requestor email address *

Requestor department and base location *

Recipient

Recipient name *

Recipient telephone number *

Recipient email address *

Recipient department and base location *

Delivery location/address *

Cost Approval

Justification for request (business case) *

Budget code to be used *

including subjective

Budget holders name *

Budget holders email address *

Supporting Documentation

Please attach your supporting documentation, i.e. "cost approval email", to support your request.

Mobile number of existing contract *

Which NHS organisation is the contract being ported to? *

Is there a device to be returned to Mobile Support Team? *

Yes

How to find the serial number

How to find the serial number
iPhone https://support.apple.com/en-gb/HT204073
Samsung https://www.samsung.com/uk/support/mobile-devices/how-do-i-find-the-imei-model-number-and-serial-number-for-samsung-galaxy-device/

Serial number of device *

Asset number of device *

Return label

PLEASE NOTE: Where returning a device, the previous user MUST have reset the device.

Device should be returned to your local MLCSU IT department, or posted to:
FAO IT Asset Mgmt,
1829 Building,
Countess of Chester Health Park,
Liverpool Road,
Chester
CH2 1HJ

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Mobile device form

Consent

Requestor

Recipient

Request Details

Cost Approval