PMS Only Customers: Add / Replace

Setup or replace a client computer

Use this form to request the setup of a new PC or laptop in a TMG 'PMS only' Medtech Deployment

Requestor email address: *

This is required to determine the eligibility to request changes, and where updates will be sent.

Please enter practice name: *

Is this an addition or replacement? *

Request date: *

When does this change need to be performed by?

Enter the new computer's hostname:

It is important to be accurate here; this needs to be the exact hostname setup on the computer

Enter the old computer's hostname here:

Local IT Name:

Local IT Contact Number:

Local IT Email:

First Name