Home
Results
Notice of Privacy Practices
Terms of Service
More
Use tab to navigate through the menu items.
UMMC COVID TESTING SITE IT EQUIPTMENT REQUEST FORM
Please fill out the all the fields. Allow 24 hours to process your request
Requested By:
Company
Address
Testing Start Date
Testing End Date
Start Time
End Time
Network Type
Wired
Wi-Fi
No. of Computers Required
Site IT Contact:
Name
Phone
Email
Is the contact on site or offsite?
Choose an option
arrow&v
Site Contact for UMMC:
Name
Phone
Submit
Thanks for submitting!