Data Center Rack Access Control Request Form
Request access to a data center rack by providing your details, rack information, requested access window, access purpose, and operational approval details.
Requester Information
Requester Full Name
*
First Name
Last Name
Job Title / Role
*
Organization / Company
*
Department
Work Email
*
example@example.com
Work Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Rack Access Request Details
Data Center / Site Name
*
Please Select
Primary Data Center
Secondary Data Center
Disaster Recovery Site
Edge Site
Colocation Facility
Other
Rack / Row / Cage Identifier
*
Access Purpose
*
Requested Access Type
*
Read-only Monitoring Access
Hands-on Rack Access
Temporary Maintenance Access
Emergency Access
Other
Access Start Date and Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Access End Date and Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Access Duration / Recurrence
Please Select
One-time access
Recurring daily
Recurring weekly
Recurring monthly
Through completion of maintenance window
Until revoked
Other
Escort Required
*
Yes
No
Special Instructions / Constraints
Authorization and Operational Details
Manager/Supervisor Name
*
Manager/Supervisor Email
*
example@example.com
Approver Name (if different)
Approval Status / Routing
*
Submit for approval
Pre-approved request
Emergency exception
Emergency Contact Name
*
Emergency Contact Relationship / Role
*
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Tools / Equipment to Be Brought In
Laptop
Console cable
KVM
Power tools
Replacement hardware
None
Additional Notes
Submit Request
Should be Empty: