Registration User Guide
Supervisors complete each field below to register one to five workforce members from UW School of Medicine (SOM), as well as ALL students, volunteers, observers, temporary staff and academic researchers for role based HIPAA, Corporate and CMS General Compliance training. UW Medicine Compliance will process within 3 business days and email login instructions to the supervisor. Let us know in the comments section if you do not have data for one of the fields why (such as volunteer, non-UW student, observer, etc.).
DO NOT submit this form for new workforce members from Airlift Northwest (ALNW), Harborview Medical Center (HMC), Northwest Hospital & Medical Center (NWH), University of Washington Medical Center (UWMC) and UW Neighborhood Clinics (UWNC) as they are automatically assigned training in the UW Medicine Learning Management System (LMS).
To register more than five workforce members, please submit the following form to firstname.lastname@example.org
1. Last Name (legal):
2. Middle Initial:
3. First Name (legal):
4. UW Site:
Airlift NorthWestHarborview Medical CenterNorthwest Hospital & Medical CenterUniversity of WashingtonUW Medical CenterUW School of Medicine
6. Institution Assigned Unique ID (Please enter at least one; EID preferred. If neither apply, go to #7.):
7. If not an employee or UW student, please select how the learner is affiliated with UW Medicine:
International Medical StudentObserverNon-UW StudentVolunteer
8. Hire Date (mm/dd/yyyy):
9. Learner Email (AMC preferred):
10. Training Required:
---CMS General ComplianceCorporate and CMS General ComplianceCorporate ComplianceHIPAA and CMS General ComplianceHIPAA and Corporate ComplianceHIPAA ComplianceHIPAA, Corporate and CMS General Compliance
11. Supervisor/Designee Name:
12. Supervisor/Designee Email:
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