Submit a request – Department of Medicine IT Helpdesk

Please choose your issue below

Your email address

Subject(optional)

Provide a summary of your request

A member of our support staff will respond as soon as possible.

Vendor, device model information(optional)

Provide Vendor point of contact information, Vendor support agreement / contract number information, and reason for not using a DOM supported machine.

Device Information

Vendor and device model information: General Description of the purpose of the device (Microscope, freezer monitor, controller pc, imager, etc…)

Vendor Point of Contact(optional)

Vendor point of contact information

Vendor Support Agreement(optional)

Please provide Vendor support agreement / contract number information

Shared Login

Does this device require the use of shared logins? If yes, state the business case reason for this.

Shared Login Business Case(optional)

Describe why a shared login is needed for this computer.

Device Network Connection(optional)

What does the device need to connect to? (specify server and or internet URL’s)

Administristrative Access(optional)

For equipment supplied by a 3rd party vendor, will the vendor authorize administrative access to the device?

Vendor need remote control(optional)

Does the device need to be remote controlled by the Vendor?

Network Needs(optional)

Please provide as much info as you can about what the device needs to connect to and if it needs access to the DOM network, provide the specific path.

Endpoint management allowed by vendor?(optional)

Will the vendor allow endpoint management tools to be installed on the device? (Zenworks, Symantec, Secunia, Active Directory) If not, explain why it is not authorized.

Attachments(optional)

Add file or drop files here