Forms

Forms

Digital Signage Announcement/Event Publication Request Form

  • Digital Signage RequestUse this form to submit content publication requests to Dental Informatics. In order for provide Dental Informatics sufficient time to process submissions, please place requests at least three business days prior to the desired content publication date. 

Computer Account Request Forms

  • Account Deletion Request -  This form is intended to provide information to Dental Informatics in order to assist UofL's I.T. Security & Account Management unit with removal of ULSD staff, faculty, or sponsored accounts.

IRONKEY Encrypted Thumb Drives


RX Printing DEA and License # Request

  • Request For RX Printing of DEA and License # (apr-13) This form is intended to provide information to Dental Informatics in order to facilitate the request of resident’s DEA &License numbers to appear on prescriptions that are printed from within axiUm.

axiUm Request Forms

  • Clinical Notes Worksheet (apr-13 - Excel) This form provides a worksheet to submit a request for an axiUm Clinical Note Code with the minimum information required to complete the request.

  • Typodont Patient Clean-Up Form (mar-16) This web form initiates the typodont clean-up process with Dental Informatics.