Create Request - Health System IT Project Request

Please fill out all the * required fields to the best of your ability and work with your IT owner where needed prior to submitting Project Request form.
If you do not know who your IT owner is please email at uhealthitgovernance@miami.edu

*Request Name
*Description
Type 1. Health System Project
*
Budget ($)

Enter rough estimate if known, or work with your vendor and/or IT owner
to enter an approximate estimate or leave as $0.

*
Planned Start

For start and finish leave the default dates as is, if you are unsure of the
timing of the project. This will indicate to IT to work with you on establishing
the timeline.

 m/d/yyyy 
*
Planned Finish

For start and finish leave the default dates as is, if you are unsure of the
timing of the project. This will indicate to IT to work with you on establishing
the timeline.

 m/d/yyyy 
Additional Information
*
Business Sponsor

VP/Executive level who the business owner reports up to
and who typically has financial and executive oversight of the project.

*Business Owner
*Business Sponsor same as Business Owner?
*Requestor Name
*Requestor Phone Number*Requestor E-mail Address
*Requesting Department*Requester same as Business Owner?
IT Sr. Manager*Business Need/Justification/Requirements
*Existing Solution/ProcessName of Vendor/Third Party/IT In-House Team
Vendor Contact InformationIs this a new vendor?
*Budget ApprovedBudget Requirements
*Budget Detail*Funding Source
Technical Requirements
*Documentation submitted/in process?
*
Service Location

Provide specific information i.e., clinical department(s), building, location,
unit, floor, etc.

Service Location Detail
Type of Mandate/Requirement
*Strategic Alignment
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