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Bibliographic Search Request Form

If this is a Patient Emergency Rush request, please call library staff at x12276.
Name:

Title:

Department:

Voice Phone:

Fax:

Street Address:

City/State/Zip:

Email: (optional)



To help us better meet your needs, please answer the following questions:

1. Is this search to be used for patient education purposes?
Yes
No
2. Is this search related to a direct patient care or work topic?
Yes
No
3. Is this search to be used for a St. Luke's inservice program?
Yes
No
If so, date of program?

4. Is this search to be used for a student project?
Yes
No
5. Is this search for personal information only?
Yes
No
6. How would you like your search delivered?
Pick-up in Library
In-house Mailbox
Fax
Mail (USPS)
Other delivery instructions:


Search Topic: (please be as specific as possible)

In some cases, charges may apply. You will be contacted by library staff before charges are incurred.