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NEW HIRE IT EQUIPMENT REQUEST FORM
(HR Team)

NEW EMPLOYEE INFORMATION

Service Division
Speech
ABA
OT
Location Code
Region Codes
Provider Code

EQUIPMENT REQUEST

MacNeo
Yes
No
iMac
Yes
No
iPad Wi-Fi
Yes
No
iPad LTE
Yes
No
Home Visits Required?
Yes
No

Rule: Select either iPad Wi-Fi or iPad LTE - not both. iPad LTE is intended for employees who perform home visits.

REQUESTOR & SPECIAL REQUIREMENTS

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