Department of Medicine/Epidemiology User Removal Form

Please use this form to remove an employee from the Network. A notification will be sent back to you upon completion.

****Accounts will be de-activated for 30 days before they are deleted permanently.****

Division     

Date -- mm/dd/yy                 Time -- hh:mm:ss am/pm (Optional)

Delete the data in the employees personal drive?   (H - Medicine  J - DEPM)

If no, where should the data be copied to?

Location: 

Additional Instructions or comments: