These forms are fillable online, but must be printed and signed by the person requesting access. DPHHS employees must also obtain their supervisor's signature. Forms must have a signature in order for the security unit to process an access request.
Completed forms may be sent to:
Colleen Llewellyn
DPHHS Systems Security Officer
Technology Services Division
111 N Sanders, Room 204
Helena MT 59620
FAX: (406) 444-5924
Forms updated 01/2013
DPHHS Employee System/File Access Request Form |
NON-DPHHS Employee System/File Access Request Form
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Access Delete Request Form
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