External Student/Provider Account Request

For non-WesternU students or providers requiring access to the medical records system(s).
Select center for which you are requesting EHR access. If your center is not listed in the dropdown, please contact a representative from that location to verify how you will receive access to their relevant system(s).
What day will you be starting in clinic?
Please select whether this request is regarding a new account request, or a password reset for an existing account (from previous rotation).
Please select all systems you would like to reset your password for
Please enter your existing ID number for Epic. Your Epic (login) ID will be the 5 or 6-digit number issued to you during your first rotation.
Remote access is granted by necessity only. It requires approval from your supervising clinical provider or rotations coordinator and should have been discussed with you prior to submitting this request. If you are unsure whether you will require remote access, the answer is typically "no."
Please acknowledge the above statement verifying the acceptable hours of use for Epic Remote.
Please confirm you have already completed the mandatory HIPAA training for the current academic year.
Please enter any additional information that may be helpful when processing your request
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Other Fields

Your name
Verification Code