YSHM Admin

We hope that by working together with you, we can ensure that we are reaching the people in our communities to promote the importance and awareness of sexual health and wellbeing across the city and county.

All of our condom schemes are part of a wider public health initiative to; improve sexual health; reduce unprotected sex; reduce rates of sexually transmitted infections (STIs) and unplanned pregnancies for service users in Derby and Derbyshire.

The joining process is simple and straightforward, all you are required to do is complete the application process to join our Free Condom Scheme(s).

Please don't hesitate to contact us for more information on joining a scheme, please email dchst.ishsfreecondoms@nhs.net. And for guidance in completing your online registration, please watch our "how to" video.

How to register your organisation for a free condom scheme

Service User Age Range Question

Service User Age Range

Please select your service user age range; this will identify the appropriate scheme(s) your organisation can provide.

Following a successful registration your organisations can apply to provide additional scheme(s) at a later date via your HUB account

13 - 15-year olds

16 - 24-year olds

25+ year olds

Schemes

Please choose the scheme(s) you will provide in your organisation.

Organisation Details Question

Organisation Details

Please provide the details of your organisation.

Name of your organisation

Type

Website Address

Telephone Number

Address 1

Address 2

Address 3

Town

County

Postcode

Scheme Location Question

Location Details

The location from where the scheme(s) you are registering will be delivered.

This might be different from your head office or base.

Following a successful registration, your organisation can add additional locations at a later date via your HUB account.

Open access - the location is open to any service user to access within the specified age range of scheme. In this instance, your location's details will be promoted on the Your Sexual Health Matters website and you should tick the box to acknowledge your acceptance of this.

Limited access – the location is only open to a specific client group to access within the specified age range of scheme e.g. in the case of C-Scheme, school nurse service, the pupils can access the service but other young people cannot.

Name of location

District

Department

My scheme location has the same address as my organisation above

Address 1

Address 2

Address 3

Town

County

Postcode

Access

Limited

Open

Disabled Access

Public Transport

The organisation's details will be promoted on the Your Sexual Health Matters website. Please tick to indicate acknowledgement of this

Risk Categories Question

Risk Categories

Do the people that will be accessing your free condom scheme fall into any of these categories? Select all that apply.

Information Question

Information

Please provide a brief overview of your organisation and how the Free Condom scheme(s) will benefit you and your service users.

Please provide an overview of your organisation and how the organisation will deliver the scheme(s).

Description

Your Details Question

Your Details

Please provide us with your contact details and create a memorable password for your future log in purposes on the HUB.

Please do not share this login or password.

Following a successful registration process your organisation can register additional staff to your scheme(s) via your HUB account. Once registered each staff member will be notified and provided with an individual login details to their HUB account.

Operational roles:

Administrator role - non face to face / administration of scheme(s)

Practitioner role - face to face / delivering scheme(s)

First Name

Surname

Telephone Number

Job Title

Email Address

Operational Role

Administration

Practitioner

I confirm that I am the Lead and I am authorised to make decisions for my organisation

Password

Password (repeat)

Orders for the attention of

Your Localities Question

Localities

Please select the localities in which you will deliver the free condom scheme(s). Select all that apply.

Manager's Details Question

Manager's Details

Please provide us with your manager’s details. The manager will be required to verify your scheme(s) application via an email that will be sent automatically.

If you are the manager you will be required to verify your scheme(s) application via an email that will be sent automatically.

I am the manager of this organisation

My organisation and manager is aware that I am applying to this scheme

Manager's First Name

Manager's Surname

Manager's Email Address

Manager's Telephone Number

Service Level Agreement Question

Service Level Agreement

Please thoroughly read through our Service Level Agreement before committing to one of our Free Condom Schemes.

I agree to this

Welcome to the Derby and Derbyshire Sexual Health Free Condom Scheme HUB provided by Sexual Health Promotion Integrated Sexual Health Services Derbyshire Community Health Services.