New Form Request

Account Details

Details of the person who is the main point of contact for current DocuSign account

Contact Name*

Contact Email*

UW affiliation*
 Staff Faculty Student

DocuSign Account Number*

Account is part of*:
 UW Seattle UW Bothell UW Tacoma UW Medicine

Document Information

This section gathers information about new University document(s) that your team would like approved for use in DocuSign.

Approximately how many different documents does your team plan to use with eSignatures in the next 6-12 months?*

Upload blank sample files (up to 5)*
Note: Do not upload any documents with personally identifiable information.

Are these documents used only for University business?*
 Yes No Other

Will any of these documents contain or request PHI or HIPAA information?*
 Yes No Other

Will any of these documents contain or request FERPA information?*
 Yes No Other

Which kinds of documents do you want to use eSignatures for?*
 Completed documents ready for signature (e.g. a finalized contract that is ready for signature) On-demand, self-service documents that the end-user completes and signs (e.g. an online application) Other

Questions or comments?