» Independence – New PC/Employee Setup Request

This form is intended for administrators to request either a new PC setup or a new employee setup.

Printer Setup & Email Signature
Which printer(s) does the employee need?*
- Santa Paula Main Printer
- Personal Office Printer
- Other
- N/A
If other printers are needed, please list their names, model numbers and IP addresses below:*
Example:
Name: Nursing Station 2
Model: Ricoh c3003
IP Address: 192.168.93.127
Personal Office Printer: What is the make and model? Is it connected through USB or through the network? If it's through the network, what is the IP Address?*
Would you like an email signature created for this employee?*
- Yes
- No (User will create their own email signature)
How should their email signature appear?*
(Title? Direct phone line? Fax number? Any special lines/designations? Etc.)
Example:
John Smith
DON
jsmith@stphealth.com
P: 602-433-6300
F: 602-433-6414

Independence – New PC/Employee Setup Request