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IT REVIEW - NEW HIRE IT EQUIPMENT REQUEST FORM
(IT USE ONLY)

IT REVIEW

Location Code
Region Code
Provider Code
Validation:
Inventory
Available
Partial Availability
Procurement Required
Return for Clarification

INVENTORY / PROCUREMENT & ASSIGNMENT

Device
Source
Inventory
New Purchase

CONFIGURATION & DELIVERY

Delivery Method
Ship
Clinic
Direct
Email Configured
Yes
No
RingCentral Configured
Yes
No
N/A
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