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Check In/Out Vendor



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Add Asset

IT Asset
This is the user that will primarily use or be responsible for this asset.
e.g. "Joe's Laptop"
Does this asset store, receive, or transmit ePHI? *
ePHI stands for electronic protected health information.

Add Application

Applications
Does this application store PHI? *
Is the data encrypted? *

Add Vendor

Add Vendor
Address
Address
Address Line 1
Address Line 2
City
State
Zip Code

Add Employee

Please note: This will create an account for this employee in the user portal.

Add Employee
Only lower case letters (a-z) and numbers (0-9) are allowed.
Enter Email
Confirm Email
Enter Password
Confirm Password
Maximum upload size: 134.22MB
Please attach a .jpg, .png, .gif or .mpg image.

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