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First and Last Name*
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Job Title (Ex. Student, Professor, Clinical Nurse Coordinator)*
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Department (If student, enter your college major)*
Telephone (or Mobile # if working from home)
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Select Role and enter email address*
Executive (Faculty, Director, Department Account)
Health Professional (HIPAA-Compliant Account)
Staff (Clerical, I.T., Administrative Positions)
Student (PhD, Graduate, Undergraduate, Teaching Assistants)
Student Basic Account (Default)
Student Pro Account (The Pro License will be issued for the current academic year only.)
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Do you handle protected health information (PHI)?*
Are you the Meeting Host or the Meeting Scheduler?*
Will you host meetings longer than 40-minutes?*
Do you want to Live Stream on YouTube?*
Do you want to Live Stream on Facebook ?*
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Please allow 1 business day for processing. Account activation instructions will be emailed to you from Zoom.