Proxy Access Request Form

CHW, Froedtert Health and Wisconsin Diagnostic Laboratories Staff


MCW Faculty, staff, students and residents should use their MCWCORP/MCW email username and password to log onto the proxy server.

Volunteer clinical faculty, adjunct faculty, emeritus faculty, and students in joint degree programs should fill out alternate form

Please review the form before submitting. MCW Libraries will verify your status and contact you within five to seven business days with your proxy login information.

Questions? Contact the MCW Library at (414) 955-8302 or asklib@mcw.edu between 8 a.m. and 4:30 p.m.

 

* Required Field

Name:  *

Work Email (You must use your CHW, Froedtert Health or Wisc. Diagnostic Lab. email address): 

*

Phone (w/Area Code):  *

Clinic/Institution: 

Please provide your home address:

Street Address:  *

City, State, Zip:  *

Department Affiliation: *

Notes: please provide any additional information you feel is necessary. 

 By checking this button, I am granting permission to my institution's human resources department to verify my employment status to MCW Libraries and electronically signing this request.

After submitting the form, you will see a confirmation message on your screen and you will be sent a confirming email. If you do not see either, your request form was not successfully submitted.

 
Follow:

 

Medical College of Wisconsin
8701 Watertown Plank Road
Milwaukee, WI 53226
(414) 955-8296
Directions & Maps
© 2017

 

 

Page Updated 01/26/2017
Top