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Statement of purposeHealth and Social Care Act 2008
Part 1
The provider’s name, legal status, address and other contact detailsIncluding address for service of notices and other documents
PoC1C 100457 2.00 Statement of purpose: Template for service providers 1
Please first read the guidance document Statement of purpose: Guidance for providers
Statement of purpose, Part 1Health and Social Care Act 2008, Regulation 12, schedule 3
The provider’s business contact details, including address for service of notices and other documents, in accordance with Sections 93 and 94 of the Health and Social Care Act 2008
1. Provider’s name and legal status
Full name1
CQC provider ID
Legal status1 Individual Partnership Organisation
2. Provider’s address, including for service of notices and other documents
Business address2
Town/city
County
Post code
Business telephone
Electronic mail (email)3
By submitting this statement of purpose you are confirming your willingness for CQC to use the email address supplied at Section 2 above for service of documents and for sending all other correspondence to you. Email ensures fast and efficient delivery of important information. If you do not want to receive documents by email please check or tick the box below. We will not share this email address with anyone else.
I/we do NOT wish to receive notices and other documents from CQC by email
1 Where the provider is a partnership please fill in the partnership’s name at ‘Full name’ in Section 1 above. Where the partnership does not have a name, please fill in the names of all the partners at Section 3 below
2 Where you do not agree to service of notices and other documents by email they will be sent by post to the business address shown in Section 2. This includes draft and final inspection reports. This postal business address will be included on the CQC website.
3 Where you agree to service of notices and other documents by email your copies will be sent to the email address shown in Section 2. This includes draft and final inspection reports.
PoC1C 100457 2.00 Statement of purpose: Template for service providers 2
Please note: CQC can deem notices sent to the email or postal address for service you supply in your statement of purpose as having been served as described in Sections 93 and 94 of the Health and Social Care Act 2008. The address supplied must therefore be accurate, up to date, and able to ensure prompt delivery of these important documents.
3. The full names of all the partners in a partnership
Names:
PoC1C 100457 2.00 Statement of purpose: Template for service providers 3
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