Access Request/Change Form 2011
*** SPR User Group***
Please complete this form. E-mail to your Health Authority SPR Administrator.
Requests must be sent from a designated Health Authority SPR Administrator.
*NOTE: For Surgeon access requests please use the Surgeon Access Request Form. For
Surgeon Office Staff requests please use the Surgeon Office Staff Access Request Form.
Requester’s Name:
Health Authority:
Title:
Phone Number:
E-mail:
Health Authority UserName:
HA SPR Admin. or Delegate:
Date Requested:
Change to existing User Access (Please indicate the change (s) required in this section)
User Group Required:
HA Booking Clerk
HA Analysis and Decision Support Staff
HA Management
HA SPR Administrator
Ministry of Health
ACCESS REQUIRED: (To select an option double click on the check box and set default value to Checked.)
NEW SPR USER
SPR Production
SPR Staging
SPR Test
MS DATA MART
Dashboard & Report Consumer
Excel Access to Data Cubes (req. Citrix access)
Report Builder (req. Citrix access)
TEAMSITE
Read Only
Contributor
SPR Central Office Use Only
SPR Manager or Delegate:
SPR UserID
Initial Password
Request Form Saved and Filed
DataMart Access Request to PM&R
SPR Access Complete
Teamsite Access Complete
Date Received:
PHSA Account requested
e-Form Submitted (Citrix)
Master Access List Updated
Fan-Out List
Distribution Lists (HO)
SPR-June 2011