CUH Scrub Access Request

Direct patient care providers (faculty, GME residents and fellows, medical and PA students only) who are required to wear scrubs in sterile areas, complete and submit this form for new ScrubX machine badge access or scrub credit issues.

For all surgical services staff, please request via the following link:

Surgical Services ScrubX request form

All others, please check with your department managment for scrub requirments.

DO NOT ENTER YOUR EMPLOYEE ID. Only enter your IClass, six digit badge number. The number is located on the back of your Iclass badge (Parkland if you are Parkland employed, UTSW if you are UT employed) at the very bottom, under the magnetic strip starts with either * or +. If you enter any other number, you will not be able to access the scrub machine.

Your request will be processed promptly during business hours.

Please remember to return the scrubs to the scrub machine after your rotation is over.

Thank you!

New request

* must provide value

Yes

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If this is not a new request, please describe. For example restore credit due to machine malfunction.

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Iclass BADGE NUMBER.

DO NOT ENTER YOUR UNIVERSITY ID NUMBER. ONLY ENTER YOUR ACTUAL BADGE NUMBER.

Enter your actual Iclass badge number, the six digit number, on the back, VERY BOTTOM EDGE of your UTSW or Parkland badge, under magnetic strip.

DO NOT ENTER YOUR UNIVERSITY EMPLOYEE ID/STUDENT ID NUMBER. If you do, it will delay your access.

* must provide value

Last Name

* must provide value

First Name

* must provide value

Your Current Title-choose one

* must provide value

Unit/Department/Rotation Service choose one

Enter your HOME unit only.

We will verify each unit/department so be sure you choose your home unit and not the unit where you will be floating.

* must provide value

Enter the name of your unit manager (hospital staff only) or n/a

* must provide value

Size (same size for top and bottom)

* must provide value

Your email address for confirmation/follow up

* must provide value

Please review the following important tips for University Hospital Scrubs:
• Two credits are awarded to all users at every level.
• When returning scrubs, it's important for your scrubs to be fully inserted and the door closed within 30 seconds in order to receive credit for the deposit.
• Please be sure to put one item in each section (top and bottom) in order to receive your credit.
• If you wish to change the size of the scrubs requested, it can be changed at any time directly at the machine:
 Instead of hitting the "C" button to collect your scrubs, hit "F" button and follow the prompts using the size key provided on the machine
• Do not launder or otherwise alter the scrubs in any way
• Please return all scrubs collected at the end of your shift.

I have read the guidelines and agree all scrubs are the property of UTSW and will be returned to the scrub machine.

I agree that ALL scrubs worn in COVID units must be returned to the scrub machine in the bags provided at the end of each shift.

* must provide value

Yes

reset

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