Community College of Rhode Island

Go to 50th Anniversary website

Policy and Procedure

Simulation Lab Request Form

In order to meet your simulation needs, please fill out the form and return it promptly.

Thank you.

Name of Organization _________________________________________________________

Contact person ______________________________________________________________

E-mail address _______________________________________________________________

When would you wish to use the simulation lab? How long will you need the simulation lab? Please list alternative dates as well.

_____________________________________________________________________________

_____________________________________________________________________________

What simulation scenario(s) will be utilized during this experience? Will you need to utilize one of informatics systems with the scenario (paper, electronic database)?

______________________________________________________________________________

______________________________________________________________________________

Please describe the personnel participating in this simulation experience.

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Please review the Policy and Procedure Manual located on our website at  www.ccri.edu/simulation/policy-procedure/

 

Go to top of page

This page developed and maintained by the Office of the Dean of Health & Rehabilitative Sciences. Send comments and suggestions to .


Last Updated: 1/10/11