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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
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Site Contact for UMMC:
Name
Phone
Submit
Thanks for submitting!
