VitalCore – New User Setup Requester Name txtRequesterName Email txtRequesterEmail New Employee Name txtNewEmployeeName SitePrimary Location 7001 - VitalCore Corporate7010 - JoCo Adult Residential Center7011 - JoCo Juvenile7012 - JoCo Central Booking7013 - JoCo New Century7101 - Grant County NM7104 - Otero County NM7201 - Jefferson County MO7301 - Stark County OH7302 - Stark County OH - Behavior Health7303 - Warren County OH7401 - Ottawa County MI Jail7403 - Saginaw MI7404 - Kent Co Correctional Facility7405 - Kent Co Juvenile7406 - Muskegon County Jail7407 - Muskegon County Juvenile7450 - Florida Regional Office 7501 - Jackson County MS7502 - Madison County MS7503 - Rankin County MS - Adult7504 - Rankin County MS - Juvenile7505 - Jackson County MS7506 - Harrison County MS - Adult7507 - Harrison County MS - Juvenile7508 - Central MS Correctional Facility7509 - East MS Correctional Facility7510 - Marshall County Correctional Facility7511 - MS State Penitentiary7512 - South MS Correctional Institute7513 - Wilkinson County Correctional Facility7514 - Walnut Grove Correctional Facility7520 - MS Regional Office 7550 - Galveston County7551 - Galveston County Juvenile Justice Dept7601 - Chesapeake VA Juvenile7602 - VA - Regional Office7603 - VA - Augusta Correctional Center7604 - VA - Coffeewood Correctional Center7605 - VA - Deerfield Correctional Center7606 - VA - Deerfield Work Center7607 - VA - Greensville Correctional Center7608 - VA - Greensville Work Center7609 - VA - Indian Creek Correctional Center7610 - VA - Lunenburg Correctional Center7611 - VA - St. Brides Correctional Center7612 - VA - Augusta Correctional Center7613 - VA - Augusta Correctional Center7614 - VA - Augusta Correctional Center7650 - VT - Northeast Region7651 - VT - CRCF7652 - VT - MVRCF7653 - VT - NECC7654 - VT - NSCF7655 - VT - NWSCF7656 - VT - SSCF7750 - Outagamie County Jail, WI7801 - Canyon County ID7802 - SW Idaho Juvenile7803 - Kootenai County, ID7850 - Weber County UT7902 - Jefferson County Detention Center select1111 Supervisor textbox3928 Office Phone textbox8215 Fax Number textbox1756 Mobile Phone textbox5032 Start Date dteStartDate Office 365 SubscriptionOffice 365 Subscription E5 (Office + Email + Intune + Compliance) - $57/moBusiness Premium (Office + Email + Intune) - $20/moBusiness Standard (Office + Email) - $12.50/moBusiness Basic (Email, 50GB) - $5/moKiosk (Webmail, 2GB Storage) - $2/moFrontline - Nurses, Admin Assistants, etc. (Office 365 F3, EOP2, AIP, O365 ATP P1) $16 cboOfficeSubscription Email Address textbox4578 Department Business DevelopmentCoporate - GuestCorporateCorporate - AccountingCorporate - Business DevelopmentCorporate - ConsultantCorporate - MarketingCorporate - UMCorporate StaffCorporate; FinanceHuman ResourcesInvestmentITIT - WOMOSLLegalMarketingNeed DepartmentNeed LocationPartnerRegional Administrative Staff - MSRORegional Administrative Staff - VA Regional OfficeRegional Administrative Staff - VT - CRCFRegional Administrative Staff - VT - Northeast RegionRegional Behavioral Health Staff - VT - Northeast RegionRegional IT Staff - MSRORegional MAT Staff - VT - Northeast RegionRegional Medical Staff - MSRORegional Medical Staff - VT - Northeast RegionSite Dental Staff - CMCFSite Dental Staff - Galveston CountySite Dental Staff - MCCFSite Dental Staff - MSPSite Dental Staff - Outagamie CountySite Dental Staff - SMCISite Dental Staff - WCCFSite Admin Staff - CMCFSite Admin Staff - EMCFSite Admin Staff - Galveston CountySite Admin Staff - KCCFSite Admin Staff - MCCFSite Admin Staff - MSPSite Admin Staff - MSROSite Admin Staff - Outagamie CountySite Admin Staff - SMCISite Admin Staff - WCCFSite Admin Staff - WGCFSite Administrative Staff - Chesapeake VASite Administrative Staff - Florida Regional OfficeSite Administrative Staff - Grant County NMSite Administrative Staff - Harrison County MISite Administrative Staff - Hidalgo County NMSite Administrative Staff - Jackson County MSSite Administrative Staff - Jefferson County MOSite Administrative Staff - Jefferson MOSite Administrative Staff - Jefferson County Detention CenterSite Administrative Staff - JoCo - CBSite Administrative Staff - JoCo - NCSite Administrative Staff - Kootenai County IDSite Administrative Staff - Muskegon County JailSite Administrative Staff - Muskegon County JuvenileSite Administrative Staff - Otero County NMSite Administrative Staff - Ottawa County MISite Administrative Staff - Rio Arriba NMSite Administrative Staff - SaginawSite Administrative Staff - Stark County OhSite Administrative Staff - Weber County UTSite Administrative Staff - Canyon County IDSite Administraton Staff - VT - CRCFSite Administraton Staff - VT - MVRCFSite Administraton Staff - VT - NECCSite Administraton Staff - VT - Northeast RegionSite Administraton Staff - VT - NSCFSite Administraton Staff - VT - NWSCFSite Administraton Staff - VT - SSCFSite Administratrive Staff - Otero County NMSite Administrative Staff - Ottawa County MI JailSite Administrative Staff - Warren County OHSite Behavioral Health Staff - VT - CRCFSite Behavioral Health Staff - VT - MVRCFSite Behavioral Health Staff - VT - NECCSite Behavioral Health Staff - VT - NSCFSite Behavioral Health Staff - VT - NWSCFSite Behavioral Health Staff - VT - SSCFSite Dental Staff - EMCFSite Dental Staff - KCCFSite Dental Staff - MSROSite General Account - Grant County NMSite General Account - Hidalgo County NMSite General Account - Madison MSSite General Account - Rankin MS - AdultSite MAT Staff - VT - CRCFSite MAT Staff - VT - NECCSite MAT Staff - VT - NSCFSite MAT Staff - VT - SSCFSite Medical Staff - Canyon Count IDSite Medical Staff - Canyon County IDSite Medical Staff - CMCFSite Medical Staff - EMCFSite Medical Staff - Florida Regional OfficeSite Medical Staff - Galveston CountySite Medical Staff - Grant County NMSite Medical Staff - Harrison County MSSite Medical Staff - Harrison County MS - AdultSite Medical Staff - Hidalgo County NMSite Medical Staff - Jackson County MSSite Medical Staff - Jackson MSSite Medical Staff - Jefferson County MOSite Medical Staff - Jefferson MOSite Medical Staff - Jefferson County Detention CenterSite Medical Staff - JoCo - ARCSite Medical Staff - JoCo - CBSite Medical Staff - JoCo - CBSite Medical Staff - JoCo - JuvenileSite Medical Staff - JoCo - Juvenile ; ARCSite Medical Staff - JoCo - NCSite Medical Staff - JoCo - Need LocationSite Medical Staff - KCCFSite Medical Staff - Kootenai County IDSite Medical Staff - Madison County MSSite Medical Staff - Madison MSSite Medical Staff - MCCFSite Medical Staff - MSPSite Medical Staff - MSROSite Medical Staff - Muskegon County JailSite Medical Staff - Muskegon County JuvenileSite Medical Staff - Otero County NMSite Medical Staff - Ottawa County MI JailSite Medical Staff - Outagamie CountySite Medical Staff - Rankin County MSSite Medical Staff - Rankin MI - JuvenileSite Medical Staff - Rio Arriba County NMSite Medical Staff - Rio Arriba NMSite Medical Staff - SaginawSite Medical Staff - Site Medical StaffSite Medical Staff - SMCISite Medical Staff - Stark County OHSite Medical Staff - VT - CRCFSite Medical Staff - VT - CRCF * Agency - TLC Agency StaffSite Medical Staff - VT - MVRCFSite Medical Staff - VT - MVRCF * Agency - SupplementalSite Medical Staff - VT - NECCSite Medical Staff - VT - NECC * Agency - Supplemental AgencySite Medical Staff - VT - NSCFSite Medical Staff - VT - NWSCFSite Medical Staff - VT - NWSCF * Agency - TLC Agency StaffSite Medical Staff - VT - SSCFSite Medical Staff - VT - SSCF * Agency - Cell Staff AgencySite Medical Staff - VT - SSCF * Agency - PlatinumSite Medical Staff - VT - SSCF * Agency - TLC Agency StaffSite Medical Staff - WGCFSite Medical Staff - Warren County OHSite Medical Staff - WCCFSite Medical Staff - Weber County UTSite Medical Stafff - SaginawStark CountyStie Medical Staff - JoCo - CBTerminatedVermont DOC select5329 Title Accounts ManagerAdministrative AssitantAdministrative ConsultantAdministrative OfficerAdministratorADONAgency - X-Ray TechAHSAAPRN : Advanced Practice Registered NurseAssistant Director of Health ServicesAssistant HSABehavioral HealthBehavioral Health - MastersBehavioral Health Administrative AssistantBehavioral Health APRNBehavioral Health CoordinatorBehavioral Health Direct/PsychBehavioral Health ProfessionalBehavioral Health SpecialistBHC : Behavioral Health CoordinatorBusiness DevelopmentCEMTCentral Supply ManagerCEOChairman of the BoardCharge NurseCharge RNChief Accounting OfficerChief Financial OfficerChief Legal CouncilChief of OperationChief of StaffChief Operating Officer - Clinical ServicesChief PsychiatristClinic/MH Admin. AssistantClinical DirectorCMACompliance MonitorConsultantContract DoctorDA : Dental AssistantDDS : Doctor of Dental SurgeryDDS-PTDental Assistant.Dental AsstDental DirectorDentistDirector of Dental ServicesDirector of Information TechnologyDirector of Marketing ; Acting DODirector of Mental Heatlth ServicesDirector of NursingDirector of Nursing/Site MgrDirector of OperationsDirector of Quality ImprovementDischarge PlannerDO : Director of OperationsDO : Director of Operations ; RN-PRNDoctorDON : Director of NursingDON : Director of Nursing ; Acting HSAEHR ManagerEMT/ParamedicFacility AdministratorFamily Nurse PractionerFile ClerkFNPGeneral AccountHealth Services AdministratorHealth Services Coordinator - HSCHIPAA ExpertHospital UtilizationHuman ResourcesHuman Resources - System AdminI.T. ManagerInfection Control Coord RNInterim HSAInvestorLab SupervisorLab TechnicianLCSWLegal ConsultantLMSWLNA : Licensed Nursing AssistantLNA : Licensed Nursing Assistant ; Medical Records ClerkLPN - Licensed Practical NurseLPN - Nurse PractionerLPN - Nurse PractionerLPN-FTLPN-PRNLVNM.H.Marketing CoordinatorMAT Case Manager MDMD - GeneralMD / Director of Mental Health TrainingMD/DO/General Family Med/EmergencyMed CartMed TechMedical AssistantMedical ClerkMedical DirectorMedical Director - DoctorMedical ProviderMedical Records ClerkMedical Records SupervisorMedical Records/HITMedical SupervisorMedical Supply AssistantMedication Assisted Treatment Case ManagerMental Health CoodinatorMental Health CounselorMental Health DirectorMental Health TherapistMental Health WorkerMH- APRNMidlevelMH CordinatorMH CounselorMHPMHP-PRNMid Level PA - Adavanced Practice PractitionerNeed Job ProfileNurseNurse - LPNNurse - RNNurse ManagerNurse PractitionerNursing AssistantOffice ManagerOn- Site CoordinatorOptometristPAPharmacistPharmacy DirectorPharmacy TechPhlebotomistPhlebotomy TechnicianPhysical TherapistPhysicianPresident of Business DevelopmentPresident of Clinical Affairs - Behavioral HealthPRN - MarketingPRN RNProviderPsych APRNPsychiatric Mental Health NursePsychiatristPT : Physical TherapistQBHP : Qualified Behavioral Health ProfessionalRecords ClerkRegional Business Analyst of Quality ImprovementRegional Director of Behavioral HealthRegional Director of NursingRegional Director of PsychiatryRegional Director of Quality ImprovementRegional Medical DirectorRegional Medication Assisted Treatment Care Behavioral HealthRegional Medication Assisted Treatment Care CoordinatorRegional Medication Assisted Treatment Medical DirectorRegional Office ManagerRegional PhysicianRegional Utilization Management SupervisorRN - Mental HealthRN - PRN - NurseRN (Night)RN : Registered NurseRN : Registered Nurse ; Acting HSARN MSNRN SupervisorRN/ Director of OperationsRN/Mental HealthSchedulerSecretary Admin AsstSecretary Admin Asst BHSite Medical DirectorSpecialistSpecialty Care CoordinatorStatewide Director of NursingStatewide Medical DirectorSystems AdministratorTechnology ConsultantTelepsych. Utilization Management LiaisonVice President of Human ResourcesVice President of OperationsVice President of Operations - WestVice President of Utilization ManagementVP of Medical Services - Facility AdministratorVP of OperationsVP of Operations - Mississippi RegionVP of Quality Management select6011 Machine IDTag# of machine Office is to be installed to textbox4195 EMR System Position Administrative AssistantDeputyDoctorEMTFacility AdministratorHead NurseHealth Services AdministratorMedical RecordsMental HealthNurseNurse PractitionerPASecretarySystem Administrator cboPosition Other Additional Notes/RequestsType notes of anything not covered above. txtNotes Submit ‹›×× ×