Please complete all fields marked * before submitting this form.

Please note that the contents of this form will not be encrypted upon submission. If you would prefer not to use this form to submit your information, please contact the Graphic Design Team.

Telephone: 0121 204 1514 / 1516 (internal: 51014 / 51016)
Email: Graphics@uhb.nhs.uk

If you can't see your preferred option below, please use the general order/estimate form to request a bespoke estimate.

• General request form

Your name

Payment details

Your details

If you are a member of staff at University Hospitals Birmingham NHS Foundation Trust, please enter your specialty or directorate below.

If you are not a member of staff at University Hospitals Birmingham NHS Foundation Trust, please enter the name of your organisation below.

Delivery and collection

Please enter a delivery address below. If you are a member of UHB staff, please enter a collection point (Selly Oak Hospital or Queen Elizabeth Hospital Birmingham).

Contact details

Order details

Attach files

Please attach your files, e.g. image files, PowerPoint files, Word files etc, using the button below.

We can't currently accept files totalling more than 500 KB in size via this form. If the total size of your files exceeds this limit, please email your files to us at the address below.

You can still use this form to submit the rest of your information.

Please note, you must not submit files containing the following using this form:

• Patient identifiable information
• Clinical photographs

Files containing this material may only be emailed to the Graphic Design team from a secure NHS email address (i.e. ending in ".nhs.uk" or "nhs.net") or supplied an alternative secure format.

Email: Graphics@uhb.nhs.uk

Deadline

Additional information

In submitting this order you are agreeing for the Graphics Department to recharge your department on the code provided for the design and/or print of this item. On receipt of your order we confirm cost to be charged to your code and estimated delivery date.

Timescales and delivery

Please allow a minimum 10 working day turnaround time for design and print work for quantities of up to 5,000 copies. If you request an earlier completion date, we will advise on receipt of your request whether this is possible. For larger quantities delivery time will be notified on sign-off of artwork. All items will be delivered to the address you provide or will be available for you to collect from either the Graphics Department at Raddlebarn Road, Selly Oak Hospital, or from the post room at the new Queen Elizabeth Hospital Birmingham.