Patient Care Services Administration
PCS EMPLOYEE ACCESS DOCUMENT
This form is to be completed by the supervisor/manager upon hire of an employee, updated as the employee’s access to
systems change, and to be completed upon separation.
Employee Name:
Employee Dept:
Employee Title:
Date:
EID:
Job Code:
UPON HIRING
 Place a check mark next to all IT Systems that the employee is authorized access
 Add any systems that are department specific or not listed below
 Keep in the employee’s personnel file

IT Systems
ID Badge
Access Control
PYXIS
KRONOS
Patient Safety Net
OPUS
UW NetID
AMC login/domain
UW Email Account
ORCA
MINDScape
IRIS
EPIC/ADT
HSM






Activation/Deactivation Contact
Email badging@u.washington.edu, or call 744.3386
E-mail dpsacc@u.washington.edu, or call 744.6825
Email tpt@u.washington.edu
Askkronos@u.washington.edu or call 598.2055
Email eazickle@u.washington.edu
Email sjohnsen@u.washington.edu or call 744-9283
https://info.medical.washington.edu/online/support_Forms/deactivateaccount.aspx (When an employee’s UW NetID and/or AMC Domain is
deactivated all systems using the employee’s passwords, including UW email
accounts, will be terminated.)
Email acshelp@u.washington.edu
Email hbarler@u.washington.edu
UPON SEPARATION
Email John Romanschi at miroman@uw.edu
 Fill out the Separation Email Template and send it to separation@u.washington.edu
 Use this document as a reference for activation/deactivation questions.
 Include this form in employee file
The purpose of this document is to comply with HIPAA regulations and University Policy regarding the tracking of employee access privileges and requirements for termination of those
privileges upon employee separation. UW Medicine User Access Guide: “Supervisors or managers of the workforce members must promptly report all significant changes in end-user
duties or employment status to UAA and/or system security administrators handling the user-Ids of the affected persons to keep privileges up-to-date and restricted to current job
requirements.” If you have questions please contact miroman@ u.washington.edu 744-6514
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