Website Request Form

Any University of Virginia Health System department, division, or center may publish information on the Health System server.

The request for Web space and the designation of persons responsible (Departmental Web Managers) should be approved by the head of the department or center and indicated with the request.

Department or Division Name *

Website Name

This name will appear in the banner of your website. It may be the same as your department's name or the name of your initiative.

Is this website an:*

Internet (available to Public) Intranet (only available to UVa Affiliates)

What is the difference between an internet website and an intranet website?

Internet websites are fully open and should not contain any information which is considered to be for internal only use. They are intended for public viewing, and should be created with this in mind. They may never be used to publish or share any sensitive data**.

Intranet websites can be accessed by anyone who can log into the UVa Health System's computing network. They contain information which is intended for an internal audience of users within the Health System. They may never be used to publish or share any sensitive data**.

**Examples of sensitive data include ANY identifiable patient information, social security numbers, credit card numbers, information regarding employment or compensation. If you have any questions, contact the Web Development Center.

Directory Name *

What is a directory name? When the Web Center creates your website account, they will create a folder on the Health System servers. This folder will contain your website pages and files. What name would you like to call this folder? The name cannot contain spaces, special characters, and it is recommended that the name is short. This name will help identify your department in the web address (i.e. www.healthsystem.virginia.edu/internet/yourdirectoryname/).

Does this website have any special security needs or access limitations? *

Yes No

If so, please describe them:

Is this website tied to a specific event (conference, campaign or happening with a defined date or period of time)? *

Yes No

If so, what is that event, and who is responsible for it:

Will this site be retired and removed after this event, or will it be continued on an ongoing basis?

Removed Continued Do not know

Person responsible for developing and maintaining website:

First Name*

Last Name*

UVa ID*

Phone*

Email Address*

Does this person have experience with maintaining websites using the Web Developer's Toolkit?

Yes No

The Web Development center offers a free, half-day, instructor-led training session on using the Web Developer's Toolkit each month.
In order to find out more about the training, visit our Training Opportunities page - http://www.healthsystem.virginia.edu/internet/webcenter/training/home.cfm .
You can sign up for the course at the following URL - http://www.healthsystem.virginia.edu/internet/webcenter/training/register.cfm

Supervisor giving approval:

Please Note: your supervisor will be copied on the confirmation email

Supervisor First Name*

Supervisor Last Name*

Supervisor Email Address

Please tell us how you intend to use this website and who your primary audience will be*