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  • Change in Facility Information

    Use for Personnel Name Changes, Report Distribution, Unit Name Changes, etc
  • DO NOT USE THIS FORM FOR WiFi / EMAR Information -> Take me to that form.

  • Did you check the Facility Profile in HG+ to see what additional information may be missing? Someone else may have already requested a change.

    • Medical Director
    • Pharmacy Provider
    • Quarterly Meetings Period
  •  -  - Pick a Date  :
  • If providing a personnel change:

    • Is the person replacing someone else?
    • Is their Title Changing?
    • Check your Condensed Facility Profile Sheet.
    • Are they being added to the distribution list?
    • Email address if necessary
  • Browse Files
    Cancel of
  •  -  - Pick a Date
  •    
  • Should be Empty: