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Milestone Video System Access Request Form

About this Form

Form number: 222-21


Last revised: November 2020

Department of System Wide Safety and Security Management

This form should be completed electronically (NOT handwritten) by a school administrator and/or the Security Team Leader for security personnel only. The form is to be used to grant one of three access levels to the Milestone Video System.  Only one level of access can be submitted per person:

Access Control/ Intercom Only – Allows access to the cameras that view access points into the schools.

Live View/ Playback Only- Allows access to view real time video and recorded video on the  Milestone Video System.

Live/Playback/Export- Allows access to view real time video, recorded video and allows user to export video to a specified video folder.

Form is to be submitted to DSSEM Video Records Specialist outlined in the Forms Instructions Section.

Adobe PDF Milestone Video System Access Request Form452 KEnglish

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