Compliance

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External/Escorted Visitor Request Form

In accordance with Centers for Disease Control and Prevention and Mississippi State Department of Health guidelines as of April 14, 2021, UMMC will continue to employ COVID-19 safety precautions until further notice. As such, UMMC-sponsored events should continue to operate in a virtual setting unless an extraordinary reason exists for in-person attendance. A sponsored event is defined as any gathering - whether on UMMC-owned or leased property or not - that is hosted, promoted or endorsed as being affiliated with UMMC or that uses any brand (including name and/or logo) associated with UMMC in any way. No UMMC funds or UMMC-affiliated grant funds may be used unless the guidelines listed below are met. 

A restrictive visitation policy is affecting all external visitors functioning in a UMMC business capacity. External visitors include auditors, monitors, vendors, representatives, and others. The COVID-19 Incident Command Center will review all requests regarding access to UMMC-owned or leased property. External visitors will access areas only on a qualifying event.

Complete the form below. The submitter/event planner will receive communications of the final decision.

* = Required Fields

Name of the submitter/event planner for this visit.*
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UMMC employee phone number*() -    
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The event requires (check all to verify acceptance)*







 
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Phone number of external visitor auditing/monitoring an IRB program (if applicable, otherwise enter 0)*() -    
Does the external visitor auditing/monitoring an IRB program require EPIC access?*
Visitors in a medical vendor capacity will process through VendorMate and must wear the assigned vendor identification at all times.*
I, the submitter/event planner verify the provided information is complete and accurate.*
Having submitted a request and receiving approval from the COVID-19 Incident Command Center, I attest that adherence to the guidelines will occur.*
I understand expenses associated with a UMMC approved sponsored event not complying with the guidelines above will not be eligible for prepayment or reimbursement using UMMC funds or UMMC-affiliated grant funds.*
I understand expenses associated with a UMMC approved sponsored event not complying with the guidelines above will be the event organizer's sole responsibility.*