Epic Workqueue Create/Update Request Form

Use this form to submit a request to create a new or update an existing Epic Workqueue (WQF). Submission of this form will automatically create an IS Service Request and be routed to the proper IS resources.

DO NOT include any Protected Health Information (PHI) on this form.

***Note that if you need users updated on a workqueue, you should contact your area’s designated workqueue manager and/or trainer for the update. ***

By checking this box, I am verifying that I am an Authorized Requestor in a manager/director role or a designated authorized requestor. *

Confirm

Requestor name: *

Requestor position: *

Requestor email: *

Requestor phone number: *

Practice/Location name: *

Is this request for a new or existing workqueue? *

New

Please identify the following items:

Workqueue Type: *

HB Workqueue Grouper:

Workqueue Name: *

Workqueue Supervisor: *

Is this a hospital workqueue for UH SA 10: *

Is this a hospital workqueue for UHMC SA 200: *

Describe the purpose of the workqueue and what items it should catch: *

Existing

Please identify the following items:

Workqueue ID(s): *

Workqueue Name(s): *

Workqueue Type: *

Topic: (Please explain in comment box below) *

Comment: *

Will other workqueues need to be updated with these changes? *

Comment: *