Preview of LTP Command Access Request Form

Download available

 

 

 

 

   LTP Command Post Access Request form

 

 

 

 

           Hematology Access                           _____  LTP East

 

           Chemistry Access                               _____  LTP West

 

 

 

User Name:                                                                                                                                                                      

 

Clock Number:                                                                                                                                                                

 

Requested Password:                                                                                                                                                      

 

*Note -LTP password does not expire, we will set up access with a default password if no password is requested above. Default Password: ANTECH

 

Copy Security Access level for User ID:                                                                                                                    

 

Include this user to receive QA Failure alerts    (Yes / No)

 

Include this user to receive LTP Reports   (Yes / No)     

 

Assign Sites (which labs to give access to):                                                                                                                

 

 

 

 

 

Requested by:______________________________________________________________________

Date: _____________________________________________________________________________   

 

 

 

 

Please email this request to [email protected] or fax this form to the respective IT Dept:    East IT Dept fax 516-727-4690                     West IT Dept fax 657-304-2671