Laptop Loan Request Form

Please complete the following request form to check out an available laptop or MacBook. Please note that to ensure availability, you must complete this form several days in advance. You must seek permission from Medical School Information Technology (MSIT) to download software. Please use cloud accounts such as UTH Office 365, OneDrive or UTH Share (Google Drive) to save data.

Today's Date*
MM slash DD slash YYYY
Name*
First Last
Email*
Phone*
Program Affiliation*
Advisor*

Your advisor must be a Medical School/Institute of Molecular Medicine faculty member.
Requested Pick-up Date*
MM slash DD slash YYYY
Consent*
I agree to the terms outlined below:
In November 2006, the UTHealth Information Technology Governance Council (ITGC) adopted the UTHealth Laptop Security Policy (ITPOL-007) to help thwart a growing trend of laptop theft on campus and additionally take reasonable measures to protect the data stored on these computers. In compliance with this policy, each laptop user is required to acknowledge receipt of this policy.
I recognize that University owned/leased laptop computer has been provided to me as a valued member of the University and that it can be taken away if I do not comply with University policies, including those outlined by this agreement.
I have received or read a copy of the Laptop Security Policy (ITPOL-007) and agree to abide by the provisions within the policy concerning disk encryption, use of a security cable lock, and to take necessary and prudent measures to physically secure my laptop when it's not in use.
I acknowledge that encryption software has been installed on my laptop. I also understand that the encryption software is operating system dependent and will consult with Information Technology before attempting to upgrade the operating system or install any product which may negatively impact the effective operation of the encryption software. I additionally agree not to remove, or in any way disable, the proper functioning of the encryption software installed on the laptop.
I agree to employ a 15 minute screen saver inactivity timeout on my laptop. In this manner, if my laptop is ever lost or stolen while I have left the laptop in Stand-By operation, there is an additional layer of protection for my data from unauthorized use or exposure.
I understand that data on my laptop may be backed up by information Technology Services using the University-provided backup tool (CrashPlan as of the date of this agreement). As the steward of my laptop, I will take reasonable and prudent measures to keep data on my laptop stored only in a transient state. I will become familiar with the University-provided Internet-based secure file sharing and collaboration system (SecureShare as of the date of this agreement), which can assist me in accessing files without having to store them permanently on my laptop.
I agree to physically secure the device when not in use by means of a locked office door, cabinet, or drawer. In the event I am unable to physically secure the laptop, I will contact Information Technology to obtain a laptop cable lock to better physically secure the laptop.
By submitting the agreement, the Bearer accepts the responsibility of being financially liable to The University of Texas Health Science Center at Houston for property being lost, damaged, or stolen due to negligence. (In accordance with State law as stipulated in House Bill #1673,66 Legislature, Section 8.05)