Purchase request form

University of Rochester Medical Center faculty, staff, and students may use this form to request the purchase of particular books, journals, or electronic resources. (Miner Library makes decisions about new journal subscriptions only once a year in the fall.)

If your need is more urgent (for example, a resource required for a course), please contact Angela Dixon at (585) 275-6943.

Information about you:

Your Name:
 Department:
E-mail address:
 Box:
Phone Number:

What is your affiliation & status?

Your affiliation:

Your status:

Information about the item (please complete all relevant information):

Author/Editor:
 Title:
Series:
 What is the format?
Print Electronic
Publisher/Producer:
 Place:
Date:
 Book Volumes:
Price:
 Number of Copies:
Is this title for RESERVE?
Yes No 		Course Title:

Why should the library purchase this title?

(check all that apply)
collection weak in this area
supports current research
supports clinical programs
supports curriculum
other (please explain below)

Please submit advertisement, review, or sample copy if you have based your request on such.

(Mail material to Angela Dixon at URMC, Box LIBR.)

Do you wish to be notified if Miner Library purchases this resource?
Yes No