Maestro New User Request Form
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Maestro New User Request Form
Fill out this form to request access to the Maestro mobile application.
New User Name
Reason For Request
New User Title:
New User Role
New User Phone
New User Work Email
New User Network ID
New User Location:
New User Specialty or Department:
New User NPI # (If Physician or Resident)
Enter N/A if not a physician or resident
I understand that each and every patient, whether friend, relative, friend of a friend, etc. has the legal right to confidential treatment of information about himself/herself which means that any and all information regarding that patient not be disclosed to anyone that is not involved in that patient´s current care including, but not limited to my spouse, relatives, friends, and friends that are doctors who treat the patient for other things. I also understand that as member of the Medical/Dental Staff of Hackensack Meridian Health, I have a legal duty to protect patient confidentiality. Accordingly, I pledge and assure that I will protect the patient´s right to confidentiality of any and all medical and other information.
I acknowledge the following:
1. My user identification code plus my password to the hospital information system is the legal equivalent of my signature. I will not disclose this code or password to anyone.
2. Once I have signed into the hospital information system, I will not allow anyone else to use the information system to access patient or employee information. Use of my computer access code and password by anyone else other than me is forbidden.
3. I understand that any applications or data which are provided and/or sponsored by Hackensack Meridian Health and contain patient and/or other HMH proprietary information, when used on my mobile computing device such as a phone, tablet or a laptop, will be protected in a similar manner as those provided through Hackensack Meridian Health’s other in-house computer systems. Any device that has access to such information will be secured with a Personal Identification Number (PIN) code, which will not be shared with any other individual and the PIN entry will be required anytime the device is powered on, or when the HMH provided application that has the PIN feature enabled, is initially accessed.
4. I will not attempt to learn another user identification code nor will I use any other identification code nor password other than my own.
5. If I have reason to believe that my identification code and/or password is known, lost or stolen, I will notify the Medical Staff Office or the Information Technology department immediately by contacting the Help Desk.
6. I understand that access to the system is a privilege and should be used with the utmost discretion. At no time am I authorized to use the system for other than its intended use or for my own or other´s personal gain.
7. I understand that only those individuals who have signed a user access agreement will be given access to the hospital information systems.
8. I will notify the Medical Staff Office upon any changes in group or practice affiliation.
9. I have read and understand the above and agree to be bound by each and every term. If I violate any of the above, I may be subject to disciplinary action up to and including dismissal from the Medical/Dental Staff.
I have read and agree to the above terms