Organization

CareCast # St. Luke’s Citrix

username

Last Name First MI Professional Title

(RN, LPN, CMA, etc.)

Sex Last four of Social Birthdate Security Class

(1 or 2, see below)

Epic Security Form

Office Name- Manager Name-

Office Phone #- Manager email-

Security Classes-

Clinical (1)- access to majority of patient data including lab, rad, path, etc.

Clerical (2)- only access to insurance and demographic information

Return to Scott Whitson via Courier or email to whitsosa@ihs.org

Answer all information on users. If they do not have CareCast or Citrix today, document “none”.