Web Page Finder - Web Forms

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Campus Building Drawings (Intranet Only)
This web form is for accessing available current UAMS floor plans in PDF format. New floor plans are added as they are updated and completed.

If the floor plan you need is not on this list or if a floor plan needs to be updated, please contact our architect, MJ Walker.

Capital Project Request
All requests for UAMS capital projects must be initiated on a Capital Project Request form and forwarded to the Campus Budget Office by the pertinent Divisional Budget Administrator after being approved by the divisional Dean, Vice Chancellor or Director.

Exceptions are that colleges submit their requests through the Office of the Provost and Integrated Clinical Enterprise project requests must be submitted through the ICE Core Hospital Operations office to the Budget Office.

Requests for capital projects will be reviewed by the Capital Project Committee and recommendations sent to the Executive Committee for final approval. The campus formal request for capital project submission occurs annually in late October.

Conference Room and Table Setup Request
General Information
We rent 8' tables for your function or event. Generally you can seat up to 6 people at each table. These tables can be arranged to your specifications.
Please secure the room at least 1 hour before the event to accomodate the time required for setup.

Special Events
At times we will be required to rent tables/chairs from an outside source. You will be billed at the same rate we are charged. This also includes vehicle transport fees (if applicable).

NOTE: Please make your reservations early. Late reservation fee of $15.00 will be added to any request made within two days of the event.

IMPORTANT: If alcoholic beverages are being served, you must submit a UAMS Events Request for approval before submitting this form!

Crime Reporting Form
General Information
This report form is to be used by those who wish to report a crime. If you choose to report anonymously the UAMS Police will not be able to investigate or prosecute the case. However, the information provided by this report may be included in any campus alerts or announcements, as well as utilized by our investigators. If the crime occurred off campus, we may forward the information to the jurisdiction where the crime took place.

We encourage victims of a crime to file a formal complaint with a local police department.

Data / Phone Cable Request
Complete this Online web form for all your data and/or phone cabling needs.

Departmental Risk / Exposure Assessment
This web form is used as part of the UAMS Occupational Exposure Assessment and Control Policy (Admin 11.4.04) to help identify and evaluate potentially hazardous workplace exposures to physical, chemical, biological and radiological agents.

Department Managers are required under the policy to complete (or designate an employee to complete) this exposure assessment data collection form. One form per laboratory, unit, floor, etc. should be submitted to report the potential hazards and their risk levels to OH&S. The form should be completed by January 31st of each year.

Equipment and Furniture Moving Request
General Information
   Make your reservations early, allowing a minimum two week lead time prior to your move request.
 Include all items to be moved. Items not listed on this form may be excluded.
 Services are provided with a one hour minimum charge. After the first hour, you will be billed at 15 minute increments.
 Storage boxes can be rented for $3.00 each; your department will be refunded $2.00 for returned boxes in good condition.

Floor Care Request
General Information
Campus Environmental Services provides floor care for your carpeted and tiled floors. You may schedule carpet cleaning to remove soil and stains, scrubbing of tile floors to remove marks and scuffs and stripping / refinishing of tiled floors.

Special Events
If your department is planning for a special event & would like to have the area spruced up prior to the event, it is necessary to schedule at least 2 weeks prior to the event. All floor care is done after 3:00 pm Monday thru Friday. If necessary, each department will need to schedule your personnel to be onsite to allow Campus Environmental Services entry to the area.

Fuel, Car Wash, Repair, Roadside Assistance Vendor List (Wright Express Card)
General Information
Department owned vehicles are provided with a Wright Express Card to be used for fuel, maintenance, car wash and repair service. Wright Express also offers 24 hour Emergency Roadside Assistance. All associated costs will be the department's responsibility.

You can find the nearest auto service vendor in your area that accepts the Wright Express card. Just select the desired city and it will return the service vendors for that city including the type of service they provide.

Hazardous Conditions Reporting
A hazard is defined as any thing or condition which might be dangerous to employees, students, patients or visitors at UAMS, or could result in damage to University property.

Employees are asked to complete the following information when it is believed a hazard exists at UAMS. Submission of this form will send the report to Occupational Health and Safety for their review.

ID Badge Access Request Form
General Information
Complete this web form to request ID Badge Access to a door or area.

Note: If you need a replacement ID badge, please visit the Creative Services ID Badge Info web page to learn how to obtain your replacement ID Badge.

Immediate Revoke ID Badge Access Request
General Information
The Immediate Revoke ID Badge Access is for the division/department heads needing to have an employee's ID badge access revoked quickly.

Note: If you need to access by ID badge to an area, please complete the Online ID Badge Access Request form.

Injury and Incident Report
For Patients and Visitors
All Patient and Visitor incident/injuries must be reported using the Patient Safety Event reporting program (UHC Safety Intelligence).

General Information
When completed, the Online Injury
and Incident form is sent to Occupational Health and Safety, Student Employee Health Services and the Office of Human Resources.

After submitting the completed form, a printable Injury and Incident form will be displayed for you to print and take with you to Student Employee Health Services (or to the Emergency Department for after-hours treatement). We also recommend printing a second copy of this form to give to your supervisor.

Lease Action Request
This form must be completed if you are requesting leased space.

Mail / Package Tracking
A convenient tool for looking up information about the arrival and delivery of your trackable package items (USPS, FedEx or UPS).

Trackable packages include: Express Mail®, Delivery Confirmation, Certified Mail and Registered Mail.

Move, Add, Change (MAC) Request
General Information
UAMS space, owned or leased, is considered to be owned by the UAMS system and is available to be used based on direction and assignment approved by the Executive Committee. Assignment does not imply permanence rather assignments are based on continued program justification and needs.

All requests for moving, adding or changing space must be made to Facilities Planning department on this request form.

Occupational Health and Safety Customer Satisfaction Survey
Occupational Health and Safety is committed to excellent customer service. Your feedback telling us how well we are meeting your needs and how we might improve our service is essential to our success in our efforts to better serve you.

Open Security Paper Bin Request
General Information
Have you mistakenly placed the wrong HIPAA or confidential documents into the security shred bin but you did not know who to call to have the bin opened to retreive these documents? We now have an easy way to contact us for such an occurrence.

When you submit this form we will be in contact with you soon to arrange a time to have the bin opened for you.

Operational Support Services Departments Information
General Information
This web page contains all the Operational Support Services departmental contacts, web forms and other web links for your convenience.

The Campus Operations Operational Support Services departments include:

  • Biohazard Waste Transportation Team,
  • Campus Environmental Services,
  • Landscape and Facilities Team (Grounds),
  • Moving & Surplus Pickup Team
  • and Sustainability Services.

Parking / Traffic Violation Appeal Form
A form to complete and submit to the UAMS Parking Operations if you wish to appeal your traffic violation.

Parking Application (Long Term) for Contractor / Vendor
General Information
If you are a contractor/vendor and are in need of long term parking here at UAMS, this form is for you. If you are not in need of long term parking, please do not submit this application. Short term parking is available on an hourly rate on the Parking 2 deck.

Vendor long term parking in each area is subject to space availability and if no parking spaces are available, applicants will be placed on a waiting list.

Parking Application for Employee / Student
General Information
If you are a UAMS employee or a student and in need of a parking space or you wouldd like to move to a new parking location, this form is for you. Parking Applications of those whose Department has moved from off campus to the main campus will be processed by date of hire. The off campus department head must coordinate the submission of applications with Parking Operations. If no parking spaces are available, you will be placed on a waiting list.

Special Considerations
If you are an RN that provides direct patient care in an inpatient area, please have your supervisor email UAMS Parking Operations to verify this information. You will still need to submit your application, but this extra step may allow you to be assigned parking space sooner.

For Carpool information, please refer to the UAMS Carpool Information page.
If you require ADA Accessable parking, you will get immediate deck approval.

Parking Application Status
General Information
If you have submitted a parking application for a parking space on UAMS, you can check the status of your parking application.

After entering your information, the results will show for all areas you have applied along with the waiting list ranking for each parking location you applied for.

Parking as Guest/Patient  or  Parking a Temporary Vehicle for Employee/Student
General Information
Employees and students that are on campus as a patient or a guest (of a patient) are encouraged to park in their assigned parking area if possible. In the event that is not a viable option, you may park in the Patient and Guest areas but must also contact Parking Operations to assure a parking citation is not received or complete this web form (commonly referred as the Do Not Ticket Me form).

We ask that you or family members visiting clinical facilities who are using a vehicle owned by an employee or student contact Parking Operations. This will assure that you or a family member driving a vehicle registered in an employee's name do not receive a parking citation.

Employees and students that are driving a temporary vehicle to campus that is not registered with Parking Operations are to park in their assigned parking area. Parking Operations must be contacted or complete this web form to assure a citation is not received.

Parking Operations Customer Survey
We want to thank you for giving us the opportunity to serve you. To help us serve you better, UAMS Parking Operations department seeks your input.

Community feedback is essential for providing quality customer service. This survey is designed to provide us with information upon which we can evaluate the delivery of our services and operations. Your input is valued and important to our decision making. Please take a few moments to complete the survey.

Police Department Customer Survey
The mission of the UAMS Police Department is to consistently seek ways to affirmatively promote and preserve a safe and secure academic environment, and to deliver quality police and public safety services in a professional and sensitive manner.

Your feedback is essential to making a safe campus environment. This survey is designed to provide us with information upon which we can evaluate the delivery of our services and operations. Your input is valued and important to our decision making. Please take a few moments to complete the survey. In addition, comments or suggestions are always welcome by contacting us directly at 686-7777.

Property Inventory Search (Intranet Only)
General information
A useful tool for searching UAMS Property Inventory. You can enter the:

  • Property Tag number,
  • the Purchase Order number
  • the Room Tag number (located on the hinge side of the door frame)
  • Property Item Serial #, or the
  • Department Cost Center.
You can also search using a string pattern that searches in the description, location, or department.
If there are matches found, the results return the following information:
  • UAMS Tag number
  • Purchase order number
  • Room Tag number
  • Room / Location
  • Date of last inventory
  • Old UAMS tag # (if any)
  • Age of the item
  • Model number
  • Serial number
  • Date item was tagged
  • Department Cost Center
  • Department Name
  • Building Name, and the
  • Description of the item.

Radiation Calculators
UAMS Occupational Health and Safety has collected radiation calculators for the following purposes:

  • To calculate the decay of the activity for a selected radionuclide, or
  • To calculate the estimated radiation dose to other individuals from a patient who has been administered Iodine-131, or
  • Conversion of radiation units

Recycle Bin Request Form
General Information
UAMS Sustainability Services is committed in reducing our carbon footprint at the University of Arkansas for Medical Sciences by providing the opportunity to recycle products at the many locations throughout the campus.

If you see the need for recycling bins installed in your area, please let us know by completing this request form. We will be contacting you soon to discuss your needs. Thank you for your participation in this program!

Report a Housekeeping Problem
If a housekeeping related problem needs to be addressed, we have an easy way to have this issue corrected quickly. Campus Environmental Services personnel are contacted as soon as this request is submitted and you should be in contact with a member of the CEVS team soon. (The response time may take longer before 6:00 am weekdays and on weekends.)

Respirator Approval Process - Half Face / Full Face Respirator
Since the Half Face / Full Face respirator is a tight-fitting face piece respirator, there is an approval process each wearer must complete before being fitted for the respirator. The steps below includes a medical questionnaire, training, testing and fitting of these respirators.

To be approved for the these types of respirators, you must observe all 4 steps of this process.

Step 1: Complete the Respirator Medical Evaluation Questionnaire.

Step 2: The Respirator Training must be completed before being allowed the wear a PAPR respirator.

Step 3: Fit tests are required for the use of any tight-fitting face piece respirators.

Step 4: Annual online training and hands on training is required.

(The annual training is necessary to monitor the user ability to wear the respirator correctly.)

Respirator Approval Process - N95 Respirator
Since the N95 respirator is a tight-fitting face piece respirator, there is an approval process each wearer must complete before being fitted for a the N95 respirator. The steps below includes a medical questionnaire, training, testing and fitting of the N95 respirator.

To be approved for the N95 respirator, you must complete all 3 steps of this process.

Step 1: Complete the N95 Respirator Medical Evaluation Questionnaire.

Step 2: The N95 Respirator Training must be completed before being fit tested.

Step 3: Fit tests are required for the use of any respirator with a tight-fitting face piece such as the N95 respirator. The fit tests are offered Mondays, Wednesdays and Fridays.

Respirator Approval Process - Powered Air Purifying (PAPR)
Since the Powered Air Purifying (PAPR) respirator is a tight-fitting face piece respirator, there is an approval process each wearer must complete before being fitted for the respirator. The steps below includes a medical questionnaire, training, testing and fitting of these respirators.

To be approved for the these types of respirators, you must observe all 4 steps of this process.

Step 1: Complete the Respirator Medical Evaluation Questionnaire.

Step 2: The Respirator Training must be completed before being allowed the wear a PAPR respirator.

Step 3: Hands on training is required for the use of any powered air purifying respirator.
- You must make an appointment for hands on training by calling Sonja Hart at 296-1060.

Step 4: Annual online training and hands on training is required.
- The annual training is necessary to monitor the user ability to wear the respirator correctly.

Special Event Parking
General Information
All activities on the UAMS campus begin and end with parking. We ask for your partnership in creating a positive experience for our patients and guests. Poor event planning can reflect negatively on the UAMS Campus, Event Sponsor and the Parking Operations. We ask that anyone sponsoring an event on campus coordinate their guest parking needs in advance.

  • A Special Event is defined as 10 or more "off campus" guests.
  • Requests should be submitted prior to sending invitations to guests.
  • Special Event parking should be requested using the Special Event Parking Request form. The form can be completed and submitted electronically. A printable version of our Special Event parking application can be downloaded and submitted via fax 686-8598 or interoffice mail Slot 582.
  • All requests will be processed on a space available basis.
  • If your request is approved for deck parking regular parking rates will apply. If your department chooses to provide event validations, please submit a sample of the validation you will be using. Event validations should include the name of your event along with the event date.

Surplus Chemicals - ChemShare Program (Intranet Only)
About the Program
Many chemical waste generators on campus dispose of items that are unopened. These may be surplus products, part of a process they are no longer using, or products that cannot be used due to a lab move or shut down. In order to minimize waste disposal while making good use of valuable chemicals, OH&S provides this surplus chemical redistribution program at no cost for the UAMS research community.

Requesting Chemicals
Search on our ChemShare Request Form for a list of unopened chemicals that are currently available. All chemicals are free to the UAMS Research Community. This list is updated often and is available on a first come/first serve basis.

Donating Chemicals
If you would like to donate unopened and unexpired chemicals to the ChemShare Program or you have chemicals you need to have disposed, please complete and submit the Chemical Waste Pickup request form.

Surplus Property Pickup Request
General Information
   Make your reservations early, allowing a minimum two week lead time prior to your pickup request.
   Include all surplus items to be picked up. Items not listed on this form may be excluded.
   Our normal working hours are: 7:30 am - 4:00 pm M-F

Tenantable Condition of Property Checklist
General Information
Lessor and Lessee are to review the items listed for tenantable condition. DBA is requesting this review to be conducted on a yearly basis to maintain lease premises in tenantable condition.

Please address all items listed on this form and if not applicable, note accordingly. Please refer to Tenantable Condition Guidelines Part II for a description/explanation of each item listed.

UAMS Work Permit Request
To perform Hot Work, Penetration Work, Above Ceiling Work or Lock Out/Tag Out Work, you must complete this form.

After this form is submitted, Occupational Health and Safety will be notified and this permit request will be registered in our system.

Note: This web form is available on the UAMS Intranet only.

Waste Pickup, Biohazardous
If you have biohazardous waste you need picked up or you need biohazard container supplies, this Online Request Form is for you. When the web form is completed, the Biohazard Team will be notified and will be contacting you soon.

Waste Pickup, Chemical
If you have chemical waste you need picked up, this Online Request Form is for you. When the web form is completed, OH&S will be notified and will be contacting you soon.

Waste Pickup, Radioactive
If you have radioactive waste you need picked up, this Online Request Form is for you. When the web form is completed, OH&S will be notified and will be contacting you soon.

Work Estimate Request
This request order form is used when you need a cost estimate for a specific job.

Work Order Details and Status
This web form is a useful tool to determine any specific Campus Operations work order details (including description, status and date created). If the work order has been completed you will also have the date it was completed, the corrective action and any associated work order costs.

Work Order Request
This request form is used for reporting broken or when something is not functioning properly.

Work Orders Search
This web form is a useful tool in finding submitted work orders.