Welcome to the class service request online form of the School of Medicine.
Personal Information
Name
Phone
Ex. 999-999-999
Extension
Email
Service
Event
Type
Select one...
Demostration
Lecture
Other
Panel Discussion
Small Group Discussion
Videoconference
Workshop
Date
...
Time
--
01
02
03
04
05
06
07
08
09
10
11
12
--
00
15
30
45
--
AM
PM
Duration
(hours)
Facility
Select one...
Anfiteatro I
Anfiteatro II
CIT
Multilab 5
Multilab 6
Multilab 7
PBL 374
PBL 501
PBL 511B
PBL 513B
PBL 534B
PBL 535B
PBL 566B
PBL 576B
PBL 580B
PBL 583B
PBL 585B
PBL 596B
PBL 627
Salon 545A
Salon 545B
Salon 622
Salon 822
Salon 957
Other
Equipment
Turning Point
Projector
Laptop
Audio
Screen
Videoconference
Aditionals Comments
Reload Image