Device Root Access Request Form
Submit this form to request temporary root or admin-level access to a device for approved maintenance, troubleshooting, or configuration tasks.
Full Name
*
First Name
Last Name
Department
*
Email Address
*
example@example.com
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Device Name or ID
*
Type of Access Requested
*
Root Access
Admin Access
Other
Reason for Access
*
Requested Access Start Date and Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Requested Access End Date and Time
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Supervisor or Manager Name (for approval)
*
Submit Request
Should be Empty: