Department of Medicine - Local Area Network New User Request Form

Please complete and check for accuracy, then click Submit once at the bottom of the page. All fields in red are required.

****If this person is replacing another, please remember to submit a user removal form.****

First Name:     Last Name: 
Title:                 Employee Type: 
Division:          Phone:   Fax: 
Building:         Room #  
Account Type:  PI:  (MBRC only) 
SOFTWARE

Word, Excel, PowerPoint, Access, Adobe Reader, Symantec Antivirus, Internet Explorer, Firefox, UMM Intranet, and
UMB Intranet are given to all users. If additional software is required, check the appropriate boxes.

****  Remember to apply for a UMM VPN account if the user needs access to UMM Intranet and is NOT located
in a UMM building or needs remote access from off campus.

**** UPI employees automatically get the iEmployee and UPI Intranet icons.
iClock  (UPI employees only) Microsoft Publisher 2003 IDX Web
Reference Manager 11 WordPerfect 8 STAR
Helpstar PACS/IMPAX  
other 
Adobe Acrobat 8 Standard (A license must be purchased from Software licensing for $40.)
Adobe Acrobat 8 Professional (A license must be purchased from Software licensing for $58.)

EMAIL DISTRIBUTION LISTS

Select the appropriate e-mail distribution list(s) for this user.

DOM_Directors DOM_Division_Administrators DOM_Division_Head
DOM_Faculty DOM_Directors/Managers DOM_LAN_Admin
GRECC-Admin GRECC-Lab GRECC-Faculty
GRECC-Nurse  GRECC-Staff GRECC-Trainee

SHARED DIRECTORIES

Please indicate any special directories needed and indicate Full Access or Read Only.  All users receive full access to their
respective divisions all directory.  i.e. (divuser\gastro\all...divuser\pulm\all...divuser\billing\all etc.)

Read Only   Full Access     
  Example (divuser\card\requested_directory)
Read Only   Full Access
 Example (divuser\edn\requested_directory)

Submissions will only be accepted by Directors, Managers, and Admininstrators. Once the account is setup, an e-mail will be sent
to you and the new user with the account details. If you wish to include another person on the e-mail, please enter their email address here:

IIMPORTANT INFORMATION

--If you are using Internet Explorer you may be prompted to click "OK" in order to send the form via email.

--If you are using Firefox, a new GroupWise email will be created, you must send the e-mail to submit the form. Do not change the subject!

--Regardless of the browser used, you will have a copy of the request in your Sent Items folder in Groupwise. This form is designed to
work on a computer with Groupwise installed. If you use a computer without Groupwise, the form may not submit successfully.