Office of Logistics Management Forms & Catalogs
PAR / Warehouse Forms:
The following forms are used to report annual inventory
levels, request adjustments to PAR stocking levels,
authorize users for PAR and Warehouse electronic ordering
systems, and gain permission to return unused consumable
items to the warehouse.
-
LM-3
- e-Portal Authorization - UConn
Health
-
LM-3B
- Logistics Management Report
Request
-
LM-3C - e-Portal Authorization
-
LM-3P
- e-Portal Authorization - Pharmacy
-
LM-3S
- Surplus PAR Stock Notice
-
LM-5
- Inventory Certificate
-
LM-6
- Inventory Count
-
LM-8 - PAR Request - (Select Format:
Excel or
PDF)
-
LM-10 - Bill Only
-
LM-14
- New Supply Transfer Voucher (When
transferring/borrowing supplies from
other departments)
-
IC-9
- Maintenance of Equipment Notice
- Implantable Device(s), Instruments,
or Supplies for Surgical Procedures. See
Purchasing Web Page for process
Information.
Shipping, Receiving, and Mail Distribution Forms:
These forms are used anytime something needs to leave
UConn Health. The LM-17 must be filled out any time a
FedEx, UPS or USPS package leaves the West Dock, or if a
vendor representative removes equipment from the
facility. If you have questions about outbound packages;
contact the Help Desk at x1958.
-
LM-16 -
Materials Logistics Distribution Form (Sample)
-
LM-17 -
Shipping & Return Materials Authorization Form
(HCA-614)
-
LM-18
- Mail Service Request Form
Property Administration Forms:
Effective July 1, 2017, all Property Administration
forms will be handled using the
Electronic Forms Workflow (EFW) system. The
instruction manual for the system can be found
online as well. Annual training, announced in the UConn
Health Lifeline, occurs between June and August for
first time users and those who wish to keep up to date
on any system changes. For continuity, the form options
on the new system will retain a similarity to the
original form numbers. You will be able to select the
following from the dropdown:
-
LM-1 - Move request
-
LM-2 - Disposal / Surplus request
-
IC-3/4 - Transfer or Loan into UConn Health
The new IC-3/4 has
been formatted to replace the following old
forms: - IC-1 Equipment Donation Form;
- IC-1A Art Donation Form;
- IC-2 Constructed Equipment Form;
- IC-3 Temporary Loan, Demonstration or
Trial Form;
- IIIC-4 Transfer into UConn Health Form
-
IC-5 - Takes the place of both the old IC-5
and IC-5A Property Loan Forms
-
IC-6 - Record of Property Disposition:
Transfer, Loss or Other Approved Disposition
-
IC-6A - Trade-In
-
IC-6B - Public Sale
-
IC-6C - Cannibalize - Please contact
Property Administration before using this form.
Report of Loss or Damages to Real and Personal
Property:
These forms may be required for certain property
losses. Contact the Property Administration Manager for
more information. All CO-853 forms must have a completed
IC-12 signature routing form attached. Signatures must
be obtained in the order listed on the IC-12.
-
CO-853
- Report of Adjustment to State-Owned Property
-
IC-12 -
Authorization to Submit CO-853
Fleet / Motor Pool Forms:
These forms are used to rent state vehicles for daily
or monthly usage. All drivers are subject to abide by
the policies and procedures contained within
DAS General Letter 115.
-
LM-11 - UConn
Health Fleet & Vehicle Request Form
-
LM-11A -
Permission for Home Garaging on a Continuous
Basis
-
LM-11B - Motor
Vehicle Monthly Usage Report
Records Retention Forms:
The Connecticut State Library designates the
retention periods and guidelines for all state records.
Their
website has comprehensive lists to help units
determine how long public records should be kept. OLM
also has
Records Management
Liaison Officers (RMLO) to assist units in preparing
paperwork to store or dispose of records and to answer
any questions related to records retention specific to
UConn Health.