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Epic Security Form Return to Scott Whitson via Courier or email to whitsosa@ihs.org Answer all information on users. If they do not have CareCast or Citrix today, document “none”.

CareCast #

Office Name-

Manager Name-

Office Phone #-

Manager email-

St. Luke’s Citrix Last Name username

First

MI

Security ClassesClinical (1)- access to majority of patient data including lab, rad, path, etc. Clerical (2)- only access to insurance and demographic information

Professional Title (RN, LPN, CMA, etc.)

Sex

Last four of Social

Birthdate

Security Class (1 or 2, see below)


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