Book Request FormUse this form to request a book that is not in our collections and that will be ordered for you through interlibrary loan (use the online Library Catalog to check the libraries' holdings).

Note: This service is available only to Hartford Hospital, Institute of Living, Connecticut Children's Medical Center and MidState Medical Center staff.


* = Required Field
* Date Needed:
* Name:
* Affiliated Institution
(select one):
Hartford Hospital
Institute of Living
  MidState Medical Center
Connecticut Children's Medical Center
* Dept./Unit Name (not number):
* Job Title:
*
Are you an RN or APRN? Yes No
* Are you a Student and is this request related to your course of study? Yes No
E-mail address:
* Phone/Beeper:
* Notify Me By: Email   Telephone

ISBN #:
Book Title:
Book Author/Editor:
Publisher:
Place of Publication:
Year of Publication:

  Comments/Special
  Instructions:

NOTICE: Copyright Restrictions - the Copyright Law of the U.S. (Title 17, U.S. Code) governs the making of photo or other reproductions of copyrighted material.

Under certain conditions specified in the law, libraries and archives are authorized to furnish a photocopy or reproduction.  One of these specified conditions is that the photocopy or reproduction is not to be "used for a purpose other than private study, scholarship, or research"  If a user makes a request for, or later uses, photo or other reproduction for purposes in excess of "fair use", that user may be liable for copyright infringement.

This institution reserves the right to refuse to accept a copying order if in its judgement, fulfillment of the order would involve violation of Copyright Law.

*  I have read and understand the Copyright Restrictions
 

* Security Code:
Enter the code shown above:



  

 
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