Add or replace a practice workstation

Setup or replace a client computer

Use this form to request the setup of a new PC or laptop in the Medtech Cloud Servers

Requestor email address: *

This is required to determine the eligibility to request changes, and where updates will be sent.

Please enter practice name: *

Enter the new computer's hostname:

It is important to be accurate here; this needs to be the exact hostname setup on the computer

Is this an addition or replacement? *

Enter the old computer's hostname here:

Request date / time: *

When does this change need to be performed by?

Local IT Name: *

Local IT Contact Number:

Local IT Email:

File Upload

Drag and drop files here or Browse

*Use this option if you have a Medtech form with details instead of manual entry*

Last Name