Medical Physics Network Access Request Form

Use this form to request access to Medical Physics network resources.

First name: Last name:

Email address:

What type of access are you requesting? (check all that apply) Windows Unix/Linux Medical Physics Intranet

Starting date for this access:

Are there any specific network resources that you need access to?

Are you a current UW student/employee? Yes No

User Agreement

I have read and agree to comply with the UW-Madison Section 25-3 of the Acceptable Use of Information Technology Resources Manual.

I have read and agree to comply with the Medical Physics Department Acceptable Computer Usage and Security Policy.

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