Services A-Z (177)

# Symbols A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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3rd Year General Inquiry

3rd Year Grade/Evaluation Inquiry

Submit a request for information on your evaluation or rotation grade. If you wish to provide preceptor name/email for evaluation, please utilize the monthly survey link instead.

3rd Year Hospital Onboarding & Document Submission

Submit a request if you require assistance or sign-off from CPM for hospital orientation documents or online onboarding.

3rd Year Report Concern/Issue

Submit a request if you feel there is a discrepancy on your evaluation.

3rd Year Schedule Change

Request a change in your core rotation schedule or location. Changes to rotations are rare. Please provide full explanation for the request.

4th Year General Inquiry

4th Year Grade/Evaluation Inquiry

Submit a request for information on your evaluation or rotation grade. If you wish to provide preceptor name/email for evaluation, please utilize the monthly survey link instead.

4th Year Hospital Onboarding & Document Submission

Submit a request if you require assistance or sign-off from CPM for hospital orientation documents or online onboarding.

4th Year Report Concern/Issue

Submit a request if you feel there is a discrepancy on your evaluation.

4th Year Schedule Change

Request a change in your core rotation schedule or location. Changes to rotations are rare. Please provide full explanation for the request.

A

Academic Concerns

Add/Drop Form

Add and Drop Classes

Admissions and Enrollment Data Request

Admissions Web Page Create/Edit Request Form

Select this service to request a new Admissions web page, or an edit to an existing Admissions web page.

Affiliation Agreement

Submit a request if a program advises you they do not have a current agreement with WesternU CPM

Annual Employee HIPAA Training

Annual Certification as required by the Office of Compliance for any WesternU Health Employee (Staff or Provider)

Annual Student HIPAA Training

WesternU student HIPAA training. Required to be completed once per academic year per the Office of University Compliance.

APMLE: Accommodations assistance

Request assistance with application for ADA Accommodations on the board examination. (Bullet point) You should not apply for ADA Accommodations without requesting assistance from the CPM Rotations Office

APMLE: General inquiry

Submit a request for assistance managing a concern about your exam report

APMLE: Registration

Submit a question about the registration process or for assistance registering for the exam

APMLE: Report concern/issue

Submit a question about the APMLE examination

Appointment with the Associate Dean, Clinical Education & Graduate Placement

Appointment with the Clinical/Rotations Office

Assessment Inquiries

Questions regarding exam dates or exam procedure.

Assessment Inquiries

Questions regarding exam dates and exam procedure.

Audience Response/Polling

AWS Account Request

To request an AWS Account

B

Banner Authorization Form

Request or renew Banner access. Built-in approval process will get manager approval prior to authorization being granted.

Basic HIPAA Training (Contact Tracing, Administration, University Operations)

For individuals needing to complete the basic University Compliance HIPAA Training as part of the requirements for positions in university administration/operations or contact tracing.

Blackboard

Block Scheduling For Provider

For requests to block provider schedules in Epic

Bloodborne Pathogens Training - Student Only (OSHA/External Rotation Site Requirement)

For students and/or providers required to complete the Bloodborne Pathogens Training

Broken Locker or Lock

C

Cancel TOR

Click here to cancel an existing TOR.

Canvas

CASPRWeb Application Inquiry

Submit a request if you have questions about your CASPR Application, or if you are seeking guidance/advice on Designating Programs

Change Advisor

Change my mentor

Change or Reset WesternU Password

If you have forgotten or need to change your password, please follow these instructions

Classroom & Multimedia Issue Form

Classroom & Multimedia Request

Clinical Application or System Incident

Submit an issue you're having with one of the clinical applications or systems used in the Patient Care Center (WesternU Health)

Clinical IT Issue

For issues directly (and immediately) impacting a person, group, or department.

Clinical IT Request

For (non-urgent) assistance regarding a clinical issue or request

Clinical Password Reset

For reset requests related to any clinical system

College Initiated Status Change

Computer Upgrade Request

Use this form to request a PC upgrade if you have been informed that your PC is due for an upgrade.

Confidential – Clinical Rotations (COMP)

Please use this form if you have any personal concerns that you would like management to review.(Clinical Rotations-COMP)

Core Lottery Questions

Please use this form to submit any questions about the 3rd year rotations lottery process.(Clinical Rotations-COMP)

COT Deferment Letter

Counseling/Advising

Request a meeting with CPM Rotations for help with the application process, or with Drs. Nouvong or Labovitz for advice selecting Externship/Clerkship programs.

COVID-19 exemptions

Request information regarding COVID-19 exemptions

Curriculum Inquiries

Questions regarding the student curriculum schedule or specific lectures

Curriculum Inquiries

Questions regarding the student schedule or specific lectures

D

Data Information Outlet Relocation or Addition

Service Request to relocate or add a Data Port for a wired connection.

Degree Verification

Degree Verification

Didactic Week and/or Orientation Week

Please use this form if you have any questions regarding Didactic Week and/or Orientation Week.(Clinical Rotations-COMP)

Didactics-General Inquiries

Submit a request for general inquiries about Didactic Sessions

Digital Media Conversion

Use for DVD media conversion or downloaded video file format conversion.

Document Scanning

Domain Name Request

Request New, Change or Remove a DNS entry.  Internal or External.

E

EDU Rotations Request

For Technical issues with EduRotations

E-Learning

Elective Confirmation Form (non-core sites/preceptors)

Please use this form to submit a non-core rotation confirmation.(Clinical Rotations-COMP)

Elective Request Form (core sites/preceptors)

Please use this form to submit a core site or preceptor rotation request.(Clinical Rotations-COMP)

Elentra

Emergency Funding Assistance

Enrollment Verification

Enrollment Verification

EPCS Request

Please complete the following form for any questions related to EPCS (reactivation, error messages, new device, etc)

Epic (EHR) Remote Access Request

For individuals requesting remote access to the Epic (EMR) System that have already completed the HIPAA training for the 20-21 academic year.

Equipment Rental Request

Equipment Rental Request for off-campus events. For on-campus events, please use Resource Scheduler to request equipment.

External Student/Provider HIPAA Training

HIPAA Training for non-WesternU individuals providing patient care services in conjunction with WesternU Health members or facilities.

F

File & Email Restoration

To be used if a file, folder or email is missing and you would like IT to attempt to recover it.

G

General inquiry

General Inquiry

General Inquiry

General Inquiry

General Inquiry

General Inquiry

General IT Project

Request a new IT project.

General IT Service Request

General Service Request (Clinical)

Please use the associated form to submit any clinical related requests

Google Apps Issue

Grade Inquiries

Questions regarding scores and final grades.

Grade Inquiries

Questions regarding scores and final grades

Grade/Evaluation Inquiry

Submit a request for information on your evaluation or rotation grade. If you wish to provide preceptor name/email for evaluation, please utilize the monthly survey link instead.

Grades/Evaluations - Clinical Rotations (COMP)

Please use this form if you have any questions regarding your grades or an evaluation.(Clinical Rotations-COMP)

Graphical Errors

Guest Parking Request

H

Hardware / Audio Visual Purchasing Requests

This form is to request desktops, laptops, tablets, monitors, printers/scanners, phones, accessories, and Audio Visual related items

Hospital Onboarding & Document Submission

Submit a request if you require assistance or sign-off from CPM for hospital orientation documents or online onboarding.

Hospital Site Affiliation Agreement Request (COMP)

Please use this form to request a new hospital affiliation agreement. Please ensure that your request is submitted no later than 120 days from the start date of the rotation.
(Clinical Rotations-COMP)

I

Immunization Inquiries

Request information about the required immunizations or to request your immunization status

IT Ecosystem Feedback

Submit feedback on your IT Ecosystem experience

J

Jury Summons Letter

Jury Summons Letter

L

Late Notification

Notify Clinical Rotations if you will be late for Didactics

Leave of Absence

If you are considering a leave of absence, or have questions about your current LOA, use this form to schedule a meeting with Dr. Park.

Letter of Good Standing Request

Submit request for updated Letter of Good Standing. Please include dates of rotation and full site name. Please note, check your individual Teams files first for the Letter of Good Standing before submitting ticket.

Letter of Recommendation

Letter to NBOME

Letter to USMLE

LinkedIn Learning Request

Lost Locker Key

M

Make an inquiry

Mediasite Request

Form for requests and questions related to the classroom/personal recording system Mediasite.

Mentor Change Request

Mobile App Request

Mobile Application Development

N

Name Change Request

Name Change Request

Network Files and Folder Access Services

For access to network drives such as W:\, J:\ and access to SharePoint lists

New Preceptor Credentialing Request (COMP)

Please use this form to request a new preceptor. (Clinical Rotations-COMP)

Noteworthy Characteristics

O

Opt-In Opportunity

Please use this form if you received an email regarding an opt-in opportunity.(Clinical Rotations-COMP)

Other Student Services

P

Personal Concerns

Phone/Telecom Incidents

Use this form for phone issues, such phone problems, call connectivity problems, static on the line etc.

Preceptor Comments

PreClinical Grade Inquiry

Please submit any questions or concerns regarding grades

Progress IQ

For requests and issues relating to Progress IQ

R

RealizeIT

Recognition of Club Event Series

Registration Late Fee Appeal

Process for appealing late fees assessed during a specific term.

Report a discrepancy

Report an IT Issue

Report an IT incident. An incident is considered an unplanned interruption to an IT service or reduction in the quality of an IT service.

Report concern/issue

Submit a request if you feel there is a discrepancy on your evaluation.

Report ECI Technology Issue

For reporting technical issues and/or concerns regarding the ECI Exam and Consult Rooms.

Report Issue with Clinical Hardware/Device(s)

Submit a report for any issues related to a medical device or equipment within a clinic

Reports Request

Request reports for data from Banner.

Request an additional exam review

Request an additional exam review

Request an Appointment

Request an Appointment with Faculty

Request Appointment with Rotations Coordinator

Please use this form to request a 30-minute student appointment with a Rotations Coordinator.(Clinical Rotations-COMP)

Request Official Copy

Request Unofficial Copy

Request/Submit Documents For Sites/Preceptors

Please use this form to request or submit documents to or from our office.(Clinical Rotations-COMP)

Request/Submit Documents For Sites/Preceptors

Please use this form to request or submit documents to or from our office.(Clinical Rotations-COMP)

Resource Scheduler Request

Rotation Confirmations / Denials / Cancellations

Please use this form to submit non-core rotation confirmations, denials, and cancellations.(Clinical Rotations-COMP)

Rotation Request

Please use this form to request core rotation sites or preceptors.(Clinical Rotations-COMP)

S

Schedule Change

Request a change in your clerkship schedule. Please refer to the Clinical Education Manual regarding rescheduling or cancelling externships. All changes must be approved by the Associate Dean and Manager of Clinical Rotations & Graduate Placement.

Scramble Match Inquiry

Submit a request for questions about Scramble, Match, or if you are seeking guidance/advice on Ranking for Match

Service Request

Submit a service request for Clinical Support

SGA/TownHall Requests

SharePoint Incident

Notify IT of an issue with SharePoint.

SharePoint Service Request

Request a new SharePoint site, additional site features, or changes to an existing SharePoint site.

Slate General Request

Software Development Request

SSL Certificate Request

An SSL Certificate is a type of digital certificate that provides authentication for a website and enables an encrypted connection.

Student Leader Conference Funding

Submit a form for signature

Submit a General Question

Submit a general request or inquiry

Submit Documents for Review

Submit LOA Return documentation

You can upload medical clearance letters, intent to return, or other required LOA Return documentation, by using this form.

Submit results

Submit results of any immunizations completed. Please note, you must also attach proof that you submitted a copies to Student Employee Health via Stu-Emphealth@westernu.edu

Submit your question or request

T

Technology Inquiries

Questions with curriculum related technololies, Elentra, ExamSoft, Mediasite, Top Hat,etc.

Technology Inquiries

Questions with curriculum related technologies, Elentra, ExamSoft, Mediasite, Top Hat, etc.

Telecom Service Request

There's A Problem With My TOR!

If you have any questions about your Time-off Request (existing, planned, or considered), use this form. Do NOT use this form to request time off! Use the TOR form on SharePoint for that purpose.

Transfer

Travel Submission

Submit documentation prior to CASPR/CRIP

U

Update or Submit an Application to the Ecosystem

Submit a request to either add a new application to the IT Ecosystem, or update an existing application within the IT Ecosystem.

Urgent Within 24 hours – Clinical Rotations (COMP)

Please use this form if you have an urgent issue for COMP Clinical Education Pomona or Lebanon Campus.

V

Video Conferencing Request

VSAS/VSLO

Please use this form for up to five VSAS/VSLO application(s) that you need released. If your application requires documents to be uploaded by your HOME institution, please indicate that for each application.(Clinical Rotations-COMP)

W

WesternU Health - Clinical Service Request

Request/Question

WesternU Health - Report Clinical Issue

For issues related to clinical systems or processes.

WesternU Health - Request Report

To request a billing, clinical, or security-related report.

Wireless Network Issues

Connectivity Problems over WiFi ONLY

Z

Zoom