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Home > Campuses & Centers > Medical > Academic Divisions > Allied Health Division >EMS Form

EMS Lab Equipment Request


1. Fill in all the fields at the top of the form.

2. Select one equipment category from the list in the box on the left. On the right all the equipment in that specific category will appear. Check the box(es) for all the equipment you want in the category.

3. If the equipment comes in a specific size or type, another list will appear on the right. You will need to select the one(s) you want.

4. When you click on the Add button, it will store your selected items in a temporary table. Do this for all the equipment that you need.

5. If you change your mind and want to delete an item(s) from your table, select the box in front of the specific item and click Delete.

6. By default all the selected items will have 1 quantity, but you can change the quantity by selecting the number you want from the dropdown list in the quantity column.

7. Make sure to check the acknowledgement box and enter the security code.

8. When you are done selecting all the item(s) you want, click Submit. You will receive an email notification of your order.

Faculty member making request:  
Phone number:  
Date needed:  
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