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Pyxis Application

(Please Print)

Name: (Last)_____________________________(First)________________________

User ID:________________________(Last 6 digits of your Social Security number)

Initial Password: NEW

Station Privileges: Instructor

Unit/Location:______________________ Float Area:______________________

I have verified that the information completed above is correct. I understand that I have been issued an expired password (NEW) and that it is my responsibility to select another confidential password when I first access a Pyxis Medstation. I also understand that my User ID number will remain the same, but I will change my password every six months. Bio-ID (finger mapping) sign-on is the preferred method of Pyxis access, using the password as a back up. I am aware that my User ID code will be my electronic signature for all transactions to the Pyxis MedStation System and that I am accountable for these transactions. I understand that no retrievable record of my new password exists. All of my transactions on the Pyxis Medstation System will permanently be recorded with my User ID and a time stamp and date. These records will be maintained and archived as per hospital policy and are available for inspection by the Drug Enforcement Agency (DEA) and the Board of Pharmacy.

I also understand that to maintain the integrity of my electronic signature, I must not give my personal password to any other individual.

Signature of User:__________________________ Date:____________________

Nurse Manager:__________________________________ Date:____________________

Original to Pharmacy:__________________________ Entered by:__________________

Removed by:_________________

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