* 1. Please select your employee or student type:

* 2. Please provide your demographic information as it relates to UAMS.

* 3. What was your start date (Month/Year) at UAMS Northwest?

* 4. By typing my initials below, I acknowledge that I have read/received the UAMS Northwest Emergency and Security Policies and training documentation. I have been given the opportunity to ask questions regarding this training and understand by signing this, it is for tracking purposes only.

I understand that I am still responsible to complete any training over Emergency or Security sent from my college or the UAMS Little Rock offices.