To request a website on the Perelman School of Medicine Web server that you plan to manage yourself, outside of our content management system, MODX, please fill out this form in its entirety. Any questions can be sent to psom-somweb@pennmedicine.upenn.edu. PLEASE NOTE, THIS FORM SHOULD NOT BE USED TO REQUEST A PMACS OR DOMAIN ACCOUNT. Refer to the PMACS website instead or call the help desk. If your site is for an organization within Penn Medicine which has a more clinical focus and you wish to create a web account on the Penn Medicine Web server, go to their form instead.
If "Other", please describe in Comments field below.
This will make up your URL - http://www.med.upenn.edu/accountname. 25-character limit - must be all lower case and include no spaces or other special characters.
This is the person who will serve as the main contact for this account.
Mail sent to accountname@www.med.upenn.edu will automatically forward to this address.