Course Reading Request Form-
From Dana Medical Library
Please allow 3 working days for your request to be filled.
Contact Information
*Contact Name: *Will receive a copy of the completed form.
Contact Phone number:
Contact E-mail:
Course Information
Course Director:
Instructor Name:
Course Name: Example: Generations
Course Number:
Example:MD 560
Path in COMET:
Example: Generations > Epoch II > Monday, November 8 > Epoch II Monday Night Reading
Date material needs to be available:
Copyright Permissions Information
Permissions will be obtained for one year unless noted below.
Department to be billed:
Chart String Number:
Materials Information
For books, please include: book title, book author/editor, publisher, copyright date and holder, chapter title, chapter author, and pages. Example: Sexual Medicine in Primary Care, William L. Maurice; Mosby, Inc.; ©
Mosby, Inc 1999; Chapter 1: Talking About Sexual Issues, pp. 6-20
For journals, please include: journal title, volume number, issue number, pages, date,article title, article author, publisher, and copyright date and holder. Example: BMJ. 1998 Sep 5;317(7159):637-42, Understanding the Culture of Prescribing, CC Butler, BMJ; © BMJ 1998
Citation:
Questions about the form? Contact Donna O'Malley or phone 656-4415.
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