Choices Women's Medical Center Employee Equipment Use Agreement

I acknowledge that while I am working for Choices Women's Medical Center ("CWMC") I will take proper care of all company equipment that I am entrusted with. This agreement includes, but is not limited to, laptops, cell phones and other equipment ("the Equipment").

The Equipment is the property of CWMC and issued to employees for the purpose of conducting company business. It is intended only for the use of the CWMC employee to whom it is assigned.

The Equipment may be taken home or to other locations by the employee. However, the employee is responsible, at all times, for the care and appropriate use of the Equipment.

I understand that CWMC Technology Department will have 24/7 remote access to the Equipment and digital content.

As a borrower of CWMC Equipment, I accept the following responsibilities:
• I will not install any software on the Equipment unless it has been approved by CWMC Director of IT Mark Phillips.
• I will not write on or place any labels or stickers on the Equipment.
• I will not disable or uninstall the virus protection program that is provided with the Equipment.
• I will report any problems/issues I encounter while using the Equipment to CWMC Director of IT Mark Phillips immediately.

I further understand that upon request by CWMC, or upon termination, I will return all CWMC Equipment to my supervisor and that the Equipment will be returned in proper working order. It is essential that the employee notify the Director of IT ( and CWMC CEO Merle Hoffman ( immediately if the laptop is lost or stolen. I understand I may be held financially responsible for lost or damaged Equipment. I understand that failure to return the Equipment upon request or termination will be considered theft and may lead to criminal prosecution by CWMC.

CWMC Equipment Acceptance Form

Date Assigned: May 1, 2020

Equipment Serial Number: CND9294BXO

Employee Name: Eliana Ochoa

Position: Phone Room Counselor

Phone Number:

Date to be Returned: Open

• I understand that all Equipment that CWMC has provided to me is the property of CWMC.
• I agree to the terms outlined in the Choices Women's Medical Center Employee Equipment Use Agreement.
• I understand that I will report any damage, loss, or theft of the Equipment to the Director of IT ( and CWMC CEO Merle Hoffman (
• I understand that I will not be held responsible for problems resulting from regular work-related use; however, I understand that I am personally responsible for any damage, theft, or loss of the Equipment due to negligence.
• I understand that a violation of the terms and conditions set out in the Choices Women's Medical Center Employee Equipment Use Agreement will result in the restriction and/or termination of my use of CWMC Equipment, and may result in further discipline up to and including termination of employment and/or legal action.

Items Loaned - Condition and/or Comments: (overall condition, scratches, dents, etc.)

HP 250 G7 Laptop – NEW, configured for home use
Serial # CND9294BXO

(By typing name here, you are providing a digital signature agreeing to terms)

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