Professional Documents
Culture Documents
Index
Page 1 - Instructions
This page will explain what you need to do with this form.
Page 2 - Order Form
This page is what you need to fill out to add, change or delete an account.
Page 3 - Approval for teammate purchase phones and abide by policy rules
This page is for teammates to agree to the policy rules and regulations as well as approve any payroll deduction for a
non-standard phone.
Page 4 - Equipment Guidelines
This page explains the standard devices and teammate purchase for non-standard devices.
Instructions
Please make sure you have completed your Cell Phone Policy Access Request (everyone), Star Learning Mobile Device Synchronization
Agreement, and Mobile Device Synchronization Request (for those who want to receive email on their device) before completing this
Wireless Device Action Form.
Instructions on how to submit these requests can be found at the following link while on a DaVita network: www.tinyurl.com/mds1001
For TECHNICAL SUPPORT or warranty exchange - call your carrier. You do not need any account information.
Warranty exchange for cell phones and PDAS need to be called into the carrier by the end user to complete their technical
troubleshooting. The carrier will send you a refurbished same-model device.
Note: Warranty is only 1 year long and does not cover physical or water damage. Otherwise, call you carrier at the number below.
Please do not go into a store, as the store will not be able to help you.
Verizon: 800-922-0204
AT&T: 800-331-0500
The defective phone MUST be returned to the carrier within 14 days of receipt of the replacement. If the defective phone is not
returned, we will be charged the full price of the replacement. Return instructions will be sent with your replacement.
If you have questions, please contact The IT HelpDesk at 888 782 8737
Please allow 10 business days after request approval for processing
Page 1
Instructions:
Fill out page 2 and 3 and submit by http://support.davita.com -> DaVita IT Procurement -> Mobile Devices -> New/Update Mobile Device.
Step 1: About you
User's Name:
Teammate ID *required*
Request Date:
Submitted By:
Title:
Office Phone:
Fax:
City
ST
SHIP TO:
Address
Zip
Address
ST
City
Zip
Request
New Service
or
Yes
Existing
DaVita Cell Number
Upgrade
Replacement
Area Code
Choose DaVita Standard Mobile Phone Select No Cost options for New and Upgrade Eligible
Choose DaVita WiFi Hotspot / MiFi
Billing Account #
Billing Name
Billing Address
Password or PIN
Billing City
Social Security #
(If moving to AT&T)
State
Zip
Update Teammate Information - the Teammate in Step 1 is the new assigned user of this cell phone or MiFi.
Section 3: Approval - Director approval is needed for all smartphones & MiFi devices. Manager approval is needed for basic phones
Approver
Title
Signature *Required*
Page 2
Approval
I agree that I will abide by DaVita's Wireless Device Policy published on the VillageWeb under Departments > Telecom and to my
responsibilities laid out above.
Your Name
Your Teammate ID
Your Title
Your Signature
I agree to have the one-time deduction from my payroll for the purchase of a new wireless device. DaVita is purchasing a mobile device
for me and, as a courtesy, DaVita will pay the monthly fees because I will be using the device for business. Upon the termination
of my employment, I will keep the device. I am responsible for all hardware purchases and maintenance. I also understand that
since DaVita will pay the monthly fees and because I am using this for work-related purposes, I am required to comply with
DaVita's policies and procedures.
*If the cost is not filled in with the correct cost, you will be contacted to approve the current cost.
Your Teammate ID
Your Signature
Page 3
DaVita Standards:
Carrier
AT&T
Verizon
Verizon
AT&T
Verizon
Device Type
Cell Phone
Cell Phone
PDA
PDA
Hotspot
Model
Pantech Breeze IV LG
Rivere III
Apple iPhone 5s 16GB
Apple iPhone 5s 16GB
LTE MiFi Hotspot / USB
Colors
Grey
Grey
Gold, Silver, Space Grey Black
Gold, Silver, Space Grey Black
Davita Standards: DaVita provides a No Cost option for Teammates for all providers for new service and upgrades that are
eligible for a discount.
DaVita Non-Standard: Any other cell phone or smartphone is available as a DaVita Non-Standard device after it passes Team
Unity testing for compatiblity with DaVita's security and compliance policies. All Non-Standard devices will be paid for by the
Teammate through Payroll Deduction. Only devices from the platforms iPhone (iOS), Windows phone are supported under
"Non-Standard" devices.
Not Supported: Android devices are not approved by the DaVita due to security concerns. These devices will not
be ordered on the DaVita corporate account and personal devices will not be allowed to access the DaVita network
via email synchronization.
Mobile Device Synchronization Agreement: All teammates who want to access DaVita email on their PDA must complete
the Star Learning course MDS1001, and the Mobile Device Synchronization Access Request. The course is located at http://
learn.davita.com/?code=MDS1001. Additional instructions can be found at www.tinyurl.com/mds1001
ITSS Support: The Helpdesk, also known as ITSS, will only fully support DaVita's Standard Devices. Support includes help
with a device issue due to email connection, email syncing, OS crash, etc. For a Non-Standard phone, ITSS will assist with email
set up only. ITSS cannot assist in any way with a Not Supported phone.
All Standard and Non-Standard mobile devices are compatible with DaVita's security and compliance policies.
Any Not Supported device does not meet DaVita's security and compliance policies.
For details on pricing for TM Purchase phones, contact the Provisioning Dept at "Provisioning@davita.com".
Page 4