Coastal AHEC Medical Library

(910) 343-2180

Journal Article Request Form

 

**I agree to pay $10.00 for each standard Interlibrary Loan (items

  not held in the library's collection) and $15.00 for a RUSH request.

Yes                No

 

PLEASE COMPLETE THE FOLLOWING:

Name

 

Your Hospital or Institution/Department

 

Address

 

City, State, Zip

 

Area Code & Phone Number (day)

 

Area Code & Phone Number (night)

 

Area Code & Fax Number

 

Email Address

DELIVERY OPTIONS (check one)

Doctor's Mailbox     US Mail    Interoffice Mail

Fax      Phone Call

Date of Request:       

Date Needed:      

RUSH

CITATION INFORMATION

Journal Title

 

Accession Number (AN) or Unique Identifier (UI)

 

Volume

 

Issue/Month

 

Year

 

Pages

 

Title of Article

 

Author(s)