Software License Request Form
Software License Request Form
Request a new software license by documenting the business need, security review details, and procurement requirements.
Requester Information
- Requester name
- Requester email
- Department
- Manager name
Software Details
- Software name
- Vendor name
- Software type
- Number of licenses requested
- Needed by date
Business Justification
- Business need
- Current workaround, if any
- Expected benefit or outcome
- Impact if the request is not approved
Security and Compliance Review
- Will this software access company data?
- Will this software store, process, or transmit PII?
- Will this software store, process, or transmit PHI?
- Security review notes
- Applicable compliance requirements
Procurement and Cost
- Pricing model
- Estimated annual cost
- Cost center
- Preferred vendor or quote reference
- Renewal or contract end date
Approvals and Additional Information
- Additional notes
- Supporting documents
- I confirm the information provided is accurate and complete to the best of my knowledge.
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