Firewall Change Request Form
U of L Firewall Change Request Form
The U of L Firewall Change Request form can be downloaded here and the instructions here.
Instructions for the U of L Firewall Change Request Form
Download the above form, and optionally the offline instructions. The Firewall Change Request Form should be completed by the authorized personnel only. Sections 1-10 at the top of the page should be completed by the person requesting modifications to the firewall.
- Requestor's Name (Printed): Enter the name of the person making the firewall change request.
- Requestor's Phone #: Enter the phone number of the contact person for the request.
- Requestor's Email: Enter the email address of the contact person for the request.
- Department: Enter the department name of the person making the request.
- Change Category: Mark the change category. A normal change request will be handled within two working days. An emergency change request will be handled as quickly as possible. To be an emergency the change must correct a major security risk.
- Proposed Change date: Enter the date changes to the firewall should be applied. If changes do not need to be applied on a specific date, leave this field blank.
- Requested Changes: Enter the requested firewall rule modification information. The source IP address, source port and protocol, destination IP address, destination port and protocol, action, add/remove rule and reason for change must be completed for each change requested. An example is provided on the form. If necessary, indicate additional requests on a blank page and attach to the form. To change an existing rule, delete the old one and add the new one.
- Description of What you are trying to Accomplish: Enter a brief description of what is to be accomplished with the firewall rule change. If necessary, attach additional pages.
- Expiry Date: When does the requested change expire?
- Authorized Requestor's Signature, Title: Enter the signature and job title of an authorized UofL contact. If the form is submitted by email a signature is not required, but the email must originate from an authorized UofL contact's email.
- Date: Enter the date of signature.
The bottom sections of the form will be completed by IT security staff. The form can be emailed to help@uleth.ca. Confirmation of completion of the requested change will be made to the requestor by phone or email.






