KU Wichita: Faculty Resources - Clinical Skills Lab: Reserving Items

Clinical Skills Lab

Each page of this site that includes a picture and description of the inventory available also includes a form at the bottom of the page to reserve that item. If you know the items you want to reserve, the form has been provided below as well.

For further information contact Lynnette Amey or Heather Morrison, Academic and Student Affairs, 293-2603.

To reserve an item or items, please provide the following information. Required fields are in bold.
Contact Person Reserving Item:
*First name*
*Last name*
*Affiliation*
*Department*
*Work Phone*
*E-mail*		-- include complete address (ttess@kumc.edu)
Faculty Responsible for Item (if different than above):
First name
Last name
Department
Choose Audience & Location:
*Intended Audience*
	If other, please specify:
*Location for Use*
	Specify location:
Dates:
*Enter the date needed*	-- mm/dd/yy
Enter the return date	-- mm/dd/yy
Items to be Reserved:
If available, the following item will be reserved in your name. To reserve additional items, add them in this box:
Note:
After you submit, you will receive a copy of this request in your e-mail. We will confirm if the item is available in a separate e-mail to the contact person listed on this form.
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