Uptivity Access Request Form

Smart Form Standard Web Part 2

Agent Full Name *

Agent Extension *

Agent Username (Campus Connect username) *

Agent Email *

Supervisor Name *

Supervisor Extension *

Supervisor Email *

Cisco Queue *

Phone MAC Address (12-digit hex code found on back of CISCO device) *

Record Call Copy?

Yes

Recording Role

Recording Group

Schedule Type *

Clarity Title *

Notes