UKAS Assessment and Accreditation for the Improving Quality in Physiological Services Scheme
Application Form
Notes on the completion of the UKAS Application Form for IQIPS
  1. The Applicant customer must complete, sign and submit all application information within the application pack. This includes:
  2. Application form anddeclaration
  3. UKAS Agreement
  4. UKAS Terms & Conditionsof Business forIQIPS Customers
  5. Project Plan
  1. Prior to submitting an application for assessment and accreditation, UKAS would like to strongly encourage all applicants to:
  2. Undertake a detailed self-assessment against the accreditation standard using the online Traffic Light Ready gap analysis tool
  3. Attend a UKAS preparation for accreditation workshop
  4. Carefully read the IQIPS standards, IQIPS 1: UKAS Assessment and Accreditation for the Improving Quality in Physiological Services scheme documents together with the above listed application documents and relevant UKAS publications

All relevant information is available from the UKASwebsite

3.Your completed application form together with all other signed declarations should be returned to the following address:

IQIPS Customer Service

United Kingdom Accreditation Service

Two Pine Trees

Chertsey Lane

Staines-Upon-Thames

TW18 3HR

For information on the status and progress of your application, please contact IQIPS Customer Service by  or by telephone on 01784 429000

4.Following the processing of your application, you will be issued with access to the IQIPS Web-based Assessment Tool and asked to complete any relevant sections.

All information given to UKAS for the purposes of your application will be treated in the strictest confidence.

Incomplete applications will result in a delay in processing your application. Please ensure that you have all the information required before returning your application to UKAS, and that you have read, understood and acted upon the appropriate standards, publications and any regulations.

Part 1: APPLICATION INFORMATION

1.1Specialism to which this application relates (please tick):

□ Audiology

□Cardiac Physiology

□ Gastro-Intestinal Physiology

□ Neurophysiology

□ Ophthalmic & Vision Science

□ Respiratory & Sleep Physiology

□ Urodynamics

□ Vascular Science

1.2Name of Trust/Organisation (Legal Entity)

1.3Main Address

Web address: www.
Tel: / Fax: / Email:

1.3Main Contact Person

(If the contact person is not an employee of the /organisation stated in 1.1, please state the nature of the relationship of this person with the organisation requiring UKAS services).

1.4Position

1.5 Address (if different from above)

Tel: / Fax: / Email:

1.6Invoicing address (if different from 1.2, above)

Part 2: Declaration

The organisation agrees to comply with the IQIPS standards, applicable UKAS requirements and UKAS publications listed on the UKAS website and to adapt to any changes in the requirements.

I enclose, with this application and declaration:

□ A signed copy of the UKAS Terms & Conditions for IQIPS

□ A signed copy of the UKAS Agreement

□ A project plan outlining key timelines

Please check that you have enclosed all the required documentation.
UKAS cannot proceed with your application until all of these items are present.

I declare that I am authorised, on behalf of the organisation, to submit this application, and that the information contained herein is both correct and accurate to the best of my knowledge and belief.

Signed Print name

Date Position

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