New Requests

This form is for new access requests to the Edmonton Clinic Health Academy (ECHA), and are submitted by a designated faculty/department/unit contact. Please note that processing a new request can take up to five (5) business days.

The types of access:

Type 1: Specific Space Access – Restricted to regular business hours
Options for Type 1 include; stairwells, suite(s), compact file/store room, and the mail-room corridor.

Type 2: Specific Space Access – NO time restrictions
Options for Type 2 include ; exterior access, pedways, elevators, stairwells, suite(s), compact file/store room, and the mail-room corridor.

Type 3: All Administrative Access - NO time restrictions
This access type includes; all exterior doors, pedways, and elevators, all access points into west side of Discovery Mall on levels 3, 4, and 5 (main doors, interstital doors), and all stairwells. Additional access options can requested below.

NOTE: Type 3 requests will only be considered for occupants with a compelling reason and an assigned office/workstation.
Card Holder's Information
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Include station letter
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Start date:
Type of Access Requested - Please review options carefully
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Type 1 and 2 - Select access to the following areas:

Check all that apply and enter room number(s) below. *Not available to Type 1.

Requested:




Type 3 - Select additional options:

Check all that apply and enter room number(s) below

Requested:


Additional Information for request
Add to Xerox Address Book:
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If yes, include card holder's enter code, CCID, and applicable copy/work room(s)
Authorize to use 'Rooms, Etc':
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Request reviewed, approved, and submitted by:
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