ID Badge/Access Control Card Request

Columbus Public Health ID/Personal Access Control Card Request Please complete this form to make an appointment to have your badge made.

Building Services – Access Card ID Badge

Request Type

New Employee

Card Replacement

Access Request

Reason for Replacement

Employee’s Full Name

Contact Number

Supervisor’s Name

Supervisor’s Number

Division

Job Classification

Location/Room #

Date of Birth

Height

Weight

Will not be shown on ID

Eye Color

Hair Color

Please explain your access request:

If you are human, leave this field blank.