Forms & Documentation

See below for all forms and documentation needed for access to various SVMC systems. All completed agreements should be returned to the SVMC Information Systems Helpdesk at helpdesk@svhealthcare.org or via fax (802-447-5495).

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Multi-Factor Authenticator (MFA) Agreement

Multi-Factor Authenticator (MFA) agreement. Required for access to the SVMC Remote Access system.

Download (.pdf)

Confidentiality Agreement (Employee)

Confidentiality agreement for current employee requesters.

Download (.pdf)

Confidentiality Agreement
(Non-Employee)

Confidentiality agreement for non-employee requesters.

Download (.pdf)

Guest Wireless
Internet Agreement

Request to access the GuestMAC wireless internet.

Download (.pdf)

Mobile Device Agreement (Email)

Request to add corporate email to your personal device.

Download (.pdf)

Nuntio & Pager Access Agreement

Request to access Nuntio and/or receive a physical pager.

Download (.pdf)

Organization EMR Access Agreement

Request your organization to access the SVMC EMR system.

Download (.pdf)

Forms & Documentation FAQ's

Does your organization currently have access to the SVMC EMR system?
If yes: You will need to complete a Multi-Factor Authenticator (MFA) Agreement and a Confidentilaity Agreement (Non-Employee). Both of these agreements will need to be completed by each individual that needs access to the SVHC EMR system, and signed off by their direct supervisor or director under the "approvers" fields.
If no: Your organization's director will need to complete an Organization EMR Access Agreement, which will then need to undergo an internal review process. If approved, you will then need to complete a Multi-Factor Authenticator (MFA) Agreement and a Confidentiality Agreement (Non-Employee). Both of these agreements will need to be completed by each individual that needs access to the SVMC EMR system, and signed off by their direct supervisor or director under the "approvers" fields.

You will need to complete a Multi-Factor Authenticator (MFA) Agreement and a Confidentiality Agreement (Employee). Both of these agreements will need to be signed off by your department director under the "approvers" fields.

You will need to complete a Mobile Device Agreement. This agreement will need to be signed off by your department director under the "approver" field.

Once approved, and your Multi-Factor Authenticator (MFA) is set up, you will be able to access "Clinical Workstation", which is a Citrix-based desktop which grants you access to most services and applications available at SVMC. For employees, this will allow you access to Meditech, the intranet page, email, and other services. For non-employees, this will allow you access to Meditech, as well as other services as needed.

Contact Us

For questions or concerns, please contact the SVMC Information Systems Helpdesk via phone at 802-447-5411 (internally ext. 5411) or via email at helpdesk@svhealthcare.org. We are available Monday - Friday at 8:00am - 4:30pm EST (excluding holidays).