Submit a request – Department of Medicine IT Helpdesk

Please choose your issue below

Your email address

Are you the primary contact person for this request?

Move Coordinators Name(optional)

Move Coordinators Email Address(optional)

Move Coordinators Phone Number(optional)

Division, Department, Center or Institute

NOTE: Please select appropriate Division - NOT just Department of Medicine (this is for Education, Communications, ORS, Finance, or Operations)

Do you have permission from your Division Administrator or Central Admin Leadership to relocate?

If No - Do NOT submit this form until you have approval. **AND** in the Summary blank below - please list the name(s) and associated computer or DOM number(s) for each person moving.

Subject(optional)

Provide a summary of your request

Date of Move

Current Location - Building

Please provide your CURRENT Building Name (include Address) and Office or Cube Number(s)

New Location - Building

Please provide Building Name (include Address) and Office or Cube Number(s)

New Location – Jack Number(s)

Please provide Jack number(s) by room/cube number. (i.e. DOM # - Jack #). For explanation about what a network jack is: https://helpdesk.medicine.wisc.edu/hc/en-us/articles/39180971686291-Network-Jack-Explanation Also make note of any network printers and which jack(s) they will be plugged into. (i.e. Printer # - Jack #)

Attachments(optional)

Add file or drop files here