HCA MOUNTAIN DIVISION IT&S SECURITY ACCESS REQUEST FORM 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out the 'Practice Information' section. Enter the practice/company name, address, business phone number, and fax number. Ensure all fields are completed accurately.
  3. Next, provide details about the providers at your practice. Include the full name and email of the Office Manager and IT&S contact.
  4. In the 'Personal Information' section, enter your name, professional title, home address, date of birth, personal cell number, email address, and NPI number if applicable.
  5. Select the access requests for specific locations by checking the appropriate boxes. This is crucial for ensuring you receive access to necessary systems.
  6. Review all entered information for accuracy before proceeding to sign the Confidentiality and Security Agreement located on pages 2-3 of this document.

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A health care assistant (HCA) is a person who provides basic nursing and personal care services to patients in hospitals, nursing homes, residential aged care facilities, community health centers, and clients homes.
The Health Care Assistant may be known as nurse aides (NA), orderlies, male attendants, or personal care assistant. The assistant provides personal care such as bathing, feeding and dressing.
Healthcare Assistants (HCAs) play an important part in providing excellent patient care. They work alongside, and assist, registered nurses and nursing associates. They carry out tasks such as helping patients to: wash and dress. eat and drink.
HCA Healthcares vision is focused on transforming healthcare through a commitment to patient-centered care and operational excellence. Their mission and values are all working in harmony to ensure they are the best in the healthcare industry.
Our founders envisioned an organization that would bring together hospitals to improve the practice of medicine. Today, we have the privilege of caring for patients across 190 hospitals and approximately 2,400 ambulatory sites of care in 20 states and the United Kingdom.

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HCA Healthcare, Inc. (historically known as Hospital Corporation of America) is an American for-profit operator of health care facilities that was founded in 1968.

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