Email Mailbox Access Consent Form
Email Mailbox Access Consent Form: Use this form to grant permission for access and management of an email mailbox.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Organization (if applicable)
Mailbox to be Accessed (email address or mailbox name)
*
Role or Relationship to Mailbox Owner
*
Please Select
Mailbox Owner
IT Administrator
Manager
Support Staff
Other
Reason for Access
*
Duration of Access (e.g., 30 days, until revoked)
*
Date of Consent
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature
*
Submit Consent
Submit Consent
Should be Empty: