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Remove or disable an existing user
Use this form to permanently remove or disable a current user.
Requestor Email:
*
This is used to confirm request and update / manage the ticket created
Practice Name:
*
Name of user to be disabled:
*
Please enter their full name. i.e. John Smith
Date / Time to Remove User
*
Enter the date for the user to be disabled/removed
Submit Request
Last Name
