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External Test Request
The Texas Health Resources Video Communications Department (VisCom) requires a connectivity test with external videoconferencing endpoints to assure that scheduled events will occur as intended.

It is the desire of VisCom personnel to make the technology facilitate your business objectives and be as transparent as possible in the process. To help us achieve this goal, please complete and submit the form below.

* Indicates required information
Technical Contact Information  
Business * 
City * 
State * 
Country * 
Name * 
Title * 
Department * 
Work Phone * 
Alternate Contact Info 
E-mail Address * 
Date Needed *  Calendar (mm/dd/yyyy)
Equipment Info 
Videoconferencing Endpoint Make, Model * 
Protocol Used * 

If Other, please specify:

ISDN Number, I.P. Address or SIP Name * 
Additional Info 
Authentication * 

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