Building Access Form

First Name

Last Name

Home Phone

Mobile Phone

Office Phone

Please identify the faculty and which department/unit you are with:

Enter a brief description that outlines the purpose of your work.

If you have a Unicard, please enter your 8-digit UCID number.

If you have another type of access card, please specify the card type and enter any number which appears on the card.

Do you need the existing access on your Unicard to remain?

Yes

Please indicate which areas you require access to. Include building name(s) and room number(s).

Do you require building perimeter access?

Yes

Which building entrance will you use to gain access (e.g. Health Sciences Centre, north entrance)? Will you need to access your office or lab space from the Foothills Hospital?

What type of access do you require?

Ongoing (e.g. set regular schedule, Monday to Friday)

Intermittent (e.g. one a week)

On-call (e.g. for emergencies only, or physician on-call shifts)

Other…(please specify)

Enter the start date you will require access.

Enter the end date you will require access.

Enter any additional information about the access you require.

Collection of personal information
Your personal information is collected under the authority of section 33(c) of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection or use of this information, please visit our Access to Information page.