1. Semester

  Fall   Spring   Summer   Indefinitely (Books and A/Vs Only)

2. Date Needed

Needed By:

3. Item Format

  Photocopy   Book   AV   eReserve for ITC Toolkit   eReserve for UVaCollab

Please note: You must register with ITC's Toolkit and grant us permission to load materials into your course file before submitting a request. Check http://toolkit.virginia.edu/displaydocs.html for further information.

4. Complete Citation

Type in the complete citation here, then proceed to #6. (If you are copying and pasting, leave this section blank and go directly to #5.)

Title of Book, Journal, or AV:

Volume or Edition:  Issue:  Pages:  Month:  Year:

Title of Journal Article or Book Chapter:

Call Number (Library Owned Books & AV's Only):

Author(s):

5. Ovid or Virgo Citation

Copy & paste citation from Ovid or Virgo here (one citation per form). If you are not copying & pasting, leave blank, and go to #6.

6. Copyright Policy Compliance

Does your request comply with Copyright Policy of the University of Virginia Financial and Administrative Policy Manual? (Does not apply to books.)

  Yes   No

7. Availability

Library owns (book or AV). Library does not own. Please purchase or order through ILL. Please photocopy ($3.00/article) and place on Reserve in Library. Will deliver to Library (personal copy or article). Will Fax to Library (924-0379). Messenger Mail to Library (Box 800722, Health System).

8. Comments:

9. Primary Instructor

Name:  E-Mail:

Phone:  Department:  HSC Box #:

Status:   Medical Faculty   Nursing Faculty   Health System Staff   Other

10. Alternate Contact Person (if not primary instructor)

Name:  E-Mail:

Phone:

11. Course (if applicable)

Name:  Number:

13. Loan Period (does not apply to Toolkit requests)

  2- Hour (external circulation available)   2- Hour (internal use only)

14. Charge Code (only needed for photocopy orders - $3 per item)

Number: