Ask for ANI confirmation of participation

Confirm your participation in Ask for ANI

Thank you for your interest in supporting victims of domestic abuse by participating in the Ask for ANI (Action Needed Immediately) codeword scheme.  
Please use this form to confirm your pharmacy’s participation in the scheme and to agree to the required training.  
If you do not have responsibility for agreeing to take part in this scheme on behalf of your pharmacy, please forward this form to the relevant colleague.  
If you have any questions about Ask for ANI, please email
Personal data  

The Data Protection Act 2018 governs how we use personal data. For details of how we will use your personal information and who we may share it with please see our personal information charter. This also explains your key rights under the Act, how you can access your personal information and how to complain if you have concerns. Please note, the email address you provide as part of this form will be used by the Home Office to contact you about the Ask for ANI codeword scheme only.  

You will have the option to unsubscribe from future communications on the scheme by emailing You may wish to consider providing a business or pharmacy email address, rather than a personal email address to receive these communications.  
Thank you in advance for your support with this important scheme.