College of Medicine Zoom Account Request

Please note this form is intended to be used by members of the MUSC College of Medicine only.

To begin the process, you MUST to go to musccom.zoom.us and sign in with your MUSC credentials to claim a Basic License. Please acknowledge below if you have already done this step. Zoom Sign In Images

Yes, I have signed in to musccom.zoom.usNo, I am unable to sign in to musccom.zoom.us.

We are sorry you are unable to sign in to the MUSC College of Medicine Zoom account. Please reach out to your Departmental IT Team to address this issue.

Primary User:

First Name:

Last Name:

Net ID:

MUSC Email:

Telephone:

Department Name:

We highly recommend activating licenses in pairs, so there is always a backup to launch any meetings. Would you like to add another person?

YesNo

Additional User:

First Name:

Last Name:

Email:

Net ID:

Fiscal Contact:

Fiscal Tech:

Fiscal Tech Email:

Do you intend to use Zoom for patient visits?

Intent to Use Zoom for Patient Visits:

If you are using it for patient visits for one of the special use cases, you must review and adhere to the controls set forth and initial below.

Initials:

Have you fully read the College of Medicine Zoom FAQs page? If not, please visit the Zoom FAQs page to understand what this license will and will not provide.

Yes, I have read the FAQs page and understand what this license will and will not provide.

Payment

Payment for the license(s) is required at the time of request. Please use the information below to determine the cost of your license, and provide the OurDay Funding Details.

Month of Request:

Prorated Cost per User license:

Total Amount to be Paid:

OurDay FDM Cost Center:

OurDay FDM Fund:

OurDay FDM Function:

OurDay FDM Company:

OurDay FDM Ledger Account:

OurDay FDM Revenue/Spent Category:

OurDay FDM Gift/Grant:

OurDay FDM Program:

OurDay FDM Additional Worktag: