To grant access to USA Health electronic systems, including those that
contain protected health information (PHI),
personally identifiable information (PII) and other sensitive data, all users must
be
provisioned a JagNumber (J#).
This form facilitates the communication of information to USA Health Human Resources
(HR), who assign the J#
from the secure Banner HR system.
This form is to be completed by an applicant for an Authorized User photo ID
Card for USA Health. This information will
be used to obtain a J Number in the USA Banner System for identification of the
Authorized
User while on USA Health
premises. Please present an approved Photo ID to Human Resources with form. Examples
of
acceptable Photo ID are on
back of form.
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