Twin Lakes Community Employee Access Form
HR Reviewed
Yes
No
Supervisor To Complete This Section
Date Access is Required
-
Month
-
Day
Year
Date Picker Icon
Employee's Name
First Name - Middle Initial
Last Name
New Employee
Yes
No
Change in Current Employee Access/User Rights
Yes
No
Title
Replacement for former employee: (if applicable)
Personal Cell Phone # (Required for emergency alerts)
-
Area Code
Phone Number
Department name
Department 5-digit code
Supervisor
Employee Status
Full-time
Part-time
PRN
Keys provided to employee: (if applicable)
New key requested from Maintenance
Yes
No
If so, which key?
Computer access needed?
New
Use predecessor or shared device
Type of device:
Desktop
Tablet
Laptop
Kiosk
Primary Location (building and neighborhood)
Internal email user only
*
Yes
No
Select all that apply for Email Distribution Groups
All users
Census-Summary
Dept Heads
DP Blding Staff
DP Clinical Team
DP_Move_Notifi
DP_RA
HC_Adm_Detail
HC_Adm_Sum
HC_Census
HC_DC
HCNurses
IL_Move_Out
IL_New_Resident
MC_Admissions
MC_Census
MC_Discharge
MCNurses
monetasprings@
RCC_Attendees
RCR_Attendees
Security Staff
SE/ER Team
Sr Mgmt Team
Supervisors
tlc@twinlakes
Transportation
AL_ES_Users
Grounds
HC_ES_Users
IL_ES_Users
ILNurses
Laundry_Users
Maintenance
MC_ES_Users
Security_Med
Terrace
CC_Caregivers
CC_Dietary
CC_Users
HomeCareAids
MCCNAs
Internet site access group
Senior Management Team and Supervisors
Nurses
Business Office
Activities
Dietary Managers
Remote access required (CEO approval required)
Yes
No
Email access via cell phone (ZIX required) (CEO approval required)
Yes
No
Change predecessor's outgoing email message to: (if applicable)
Access to predecessor's H drive required until date
-
Month
-
Day
Year
Date Picker Icon
Access to predecessor's email required until date
-
Month
-
Day
Year
Date Picker Icon
Relias access needed:
Learner
Supervisor
Access to PCC required
Yes
No
Credentials
CNA
NHA
RN
LPN
MSW
Other
Access to other programs needed (if applicable)
CareWhen
Worxhub
SARA
Timeclock
Other
Copier required In which buildings
Scan to Email feature required?
Yes
No
Color copies allowed
Yes
No
Individual phone extensions required for this user?
Yes
No
Desk phone location
Voice mail required
Yes
No
Company cell phone provided? (CEO approval required)
Yes
No
Locker required?
Yes
No
Locker location
Combination
Receive escalation message after non-response to SARA alert?
Yes
No
If yes, preferred method of access
Email
Cell
Text
Submit
Should be Empty: