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* 1. Please enter your information.

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* 2. Select student type in drop down. If your type is not listed, please use the text box.

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* 3. Please select school. If not listed, use Other.

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* 4. I hereby attest that I have reviewed and am aware of the Information and Technology Services nine statements and procedures. I received a copy of these policies and procedures and I am able to ask my clinical coordinator any questions or concerns in regards to HITRUST.

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