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User Access Request Form
User Access Request Form
Requestor Information
Requestor Name
Department Name
Phone Number
Email Address
Requested Access
Please select...
Atrium Admin Mgmt
Atrium Security Access Mgmt
Action
Action
Add a new user
Remove a user
User Name
User Empl ID
*NOTE
a
"
UCard Confidentiality and Acceptable Use Agreement
" form must be signed and received by our office before requested Action is taken.
Department Head Authorization
Supervisor Name
Supervisor Phone Number
Supervisor Email Address
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Last Updated: 3/16/22