IT Forms

Form (click to download)


Complete this form to create, modify, or revoke accounts for network, email, IDX, Siemens or to request remote access for new and existing employees, vendors, etc. at UConn Health and its affiliated providers.

Only UConn Health employees have access to UAR. 

Help and FAQs are available from within the UAR application. 

This is the new request form for patient data (formerly called the ADS Request form). Please use this request form from this point forward when requesting information from Enterprise Computing Services (IT). Complete and email to (ADS, Request).

Please note the policies regarding the release of patient data have been updated to reflect the more stringent requirements outlined by HIPAA (The Health Insurance Portability and Accountability Act of 1996) which further protects the use and disclosure of patient identifiable information.

Access the current UConn Health policy on the release of patient specific data, which is subject to change as we work toward compliance with HIPAA regulations.

View the Confidentiality Reminder that will accompany all releases of patient specific data, as notice to you that each release of data must only be used for the stated purpose in your request.

Complete this form to request that a computing device (not a personally-owned mobile computing device such as a smartphone or tablet) be excluded from whole drive encryption as part of the Basic Sciences.

Complete this form to request a new cell phone device or service.

Pager Request Form

Complete this form to request a new pager or paging service.

Telephone Directory Update

To update information, email your changes to Directory Updates.

Complete this form to create, modify, or revoke user accounts for VOALTE. As a Manager/Supervisor, after you complete this form you must also:

  • Send the signed, completed form (named as users active directory.pdf) to
  • Send a headshot photo (named as users active directory.jpg)
  • Schedule training session with SPED at x2002 for all Voalte One and Messenger or 
  • Schedule a provisioning and tutorial session with Mobile Device Team at x4400 for all VoalteMe.