TeamWorks Access Request Form

I understand that TeamWorks is the proprietary software, used to support and maintain the organization's core operational information in a centralized database. TeamHealth's Facility Contracting, Recruiting, Clinician Onboarding, Provider Contracting, Credentials Coordination, Provider Enrollment Scheduling and Payroll process areas are supported by TeamWorks. This system is tightly integrated with executive management reports and other business systems such as; Application Generation, Clients for Life Online, SilkRoad, OnBase, etc., to ensure accuracy and consistency. Sensitive Clinician data is housed in TeamWorks such as; Name, Address, Phone Numbers, Full DOB, Full SSN, Health Information, Malpractice and Compliance Information, Medical License, DEA & Controlled Substance License information (including access to copies of the documents), etc. Access to this data is dependent on the role(s) granted to the user based on the information provided in this request. TeamWorks is not automatically granted to all TeamHealth Employees and access is regularly audited. Access to this database can and will be revoked due to inactivity or abuse.

I Agree You are required to check "I Agree" before you can proceed with your Request.

User Lookup

First Name

Please enter a valid first name

Last Name

Please enter a valid last name

Please enter a valid email

TeamWorks Title

Please enter a valid title

Primary Group

Please select a Primary Group

Note: Users working in TeamWorks Process Areas that have securities tied to "Payroll Companies" will be granted all "Payroll Companies" marked as "Active" within all group(s) selected, (as the time of account creation). Examples of such roles are Payroll and Finance.

Secondary Groups Control click to select multiple

Additional Group(s): If this individual will need access to groups other than the Primary Group they can be requested under Secondary Groups. Select any additional group(s) in which this user should have view, add, edit and/or delete data capabilities (depending on the access granted).

Request Type

Please select a Request Type

Comments

Focus / Process Area Selection

Please select a Focus Area

Request Approval

I am this individual's Manager and would like to approve this request.

I am not this individual's Manager. Please forward this request to the Manager on record shown above.

I am not this individual's Manager. Please forward this request to the Manager selected below.

Please make a selection

PLEASE READ AND INDICATE BY EACH STATEMENT THAT YOU AGREE

1. By signing this document, I agree to oversee this individual's use of TeamWorks and will notify the Service Desk as soon as possible should this user's relationship with TeamHealth end or they no longer need access.

2. TeamWorks is audited both internally and externally. Inactive accounts may become disabled due to inactivity or abuse.

3. Roles are reviewed for appropriateness during audits and I may be questioned about the need for access.

Selecting 'Submit Request' below begins a process that first sends an approval request to the manager indicated above. Once approval is given, the request is forwarded to IT Account Management who will process the request. Notification will be sent to the individual when the TeamWorks account has been created.

Select Manager

Selected Manager Details