In order to access the VCU School of Medicine resources from off-campus locations, employees must use a secure connection from a secured computer. This web form is provided for employees to request remote access to VCU School of Medicine network resources and denotes the responsibilities of a remote access user.


Requester: Complete Sections 1 - 2 of the form then click "Save and Return" at the bottom. Copy or note the Return Access Code. Select the "Email Survey Link" option and enter your supervisor / department head / administrator's email address so they can finish completing the survey for you.

Supervisor / Department Head / Administrator: Upon receiving the Return Access Code, go to the web form link provided in the email (or by accessing the "Returning?" link in the top right corner of the following webpage: and enter the Return Access Code. Next, complete section 3 of the form and then click Submit. You will receive a confirmation email once your form has been submitted and is in the SOMTech queue for processing.

If you need assistance or have questions while completing this form, please email

Please allow up to 2 business days for processing.

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Section I. Requester Information (to be completed by Requester)
Section II. Requirements and Certification (to be completed by Requester)
Section III. Supervisor / Department Head / Administrator Signature and Contact Information (to be completed by Supervisor / Department Head / Administrator

NOTE: The section below is to be completed by your supervisor / department head / or administrator. Please "Save for Later," note the Access Code given, and then "Email Survey Link" to your supervisor. Your supervisor will need the Access Code to proceed with and submit the form.
You have selected an option that triggers this survey to end right now.
To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.