New Account Request - College of Pharmacy Computing Systems Services

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College of Pharmacy
30 South 2000 East
SLC, UT 84112-5820
phone: 801-581-6731
fax: 801-581-3716

PharmD.Admissions
@pharm.utah.edu

CPCSS - New Account Request

- Requesting an account agreement -

The supervisor may designate a proxy to issue account requests, e.g., an administrative assistant (not the new user).
The supervisor and/or proxy making the request takes responsibility for the request.
- The supervisor/proxy vouches for the authenticity of the new user.
- The new user is officially associated with the College of Pharmacy
- The new user has official and legitimate needs to have access as requested, e.g., to complete work assignments or store institutional data.
Account requests are for students, staff, faculty, visiting scholars, guests and/or others with official and legitimate needs to have the access requested.
An email confirmation for the new account request may be required from the supervisor.

Supervisor Making Request
* Supervisor Name:
* Supervisor Email Address: (must be a "utah.edu" address)
* Proxy?:	Yes No
* Proxy Name:
* Proxy Email:

New Account / User Information
Additional Account Type(s): (optional)	Citrix/Metaframe VPN Olympus/eChart/PowerChart
*uNID (u0000000):
* Status:
* User's Full Name:	Last/Surname: First/Given Name:
* Department:	Group:
* Graduation Date: (or expected employment duration)
* Phone Number: (work only)
* Office Location: (where duties performed)	Room:
Comments (320 Max Characters)
* required

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