Education

Use this form to have a bibliographical search done by a health information specialist. The request will be sent to a mailbox that is checked regularly, Monday through Friday. If there are any questions concerning your request, you will be contacted by a health information specialist within one business day. Search results will be provided by the due date specified by the client; however, patient care requests receive first priority. If there will be any problem meeting your requested deadline, you will be contacted by a health information specialist.

Please fill out the form completely before pressing the submit button.

Client Information

Name: *

E-Mail address: *

Phone Number:

Beeper:

Please select your primary affiliation: - None -Allegheny General HospitalAGH Suburban CampusAMPN, Allegheny Medical Practice NetworkASPN, Allegheny Specialty Practice NetworkASRICanonsburg HospitalOther

Department/Unit:

If you selected other above, please specify here:

Please select status: - None -PhysicianScientistManagerNurseResidentFellowAdministratorClerical/SupportAllied HealthMedical StudentOther Professional

Address: Building name and address (e.g. South Tower, 2nd floor) Or Mailing address if you have no interoffice mail :

Search Request

Date search results needed by:

When Search is completed: - None -Page mePhone meE-mail resultsMail results

Purpose of the search: - None -Patient careGrant developmentResearchContinuing educationProfessional lecture/publicationManagement/administrationOther

If you selected other above, please specify here:

In sentence form, please describe your request:

Do you want your results limited to English language:

Yes

No

Do you want your search restricted to animal or human subjects:

Animal

Human

Both

Do you want your search restricted to male or female:

Male

Female

Both

Do you want your search restricted to specific age groups (choose all that apply):

No restrictions

Pregnancy

Infant, to 1 month

Infant, 1-23 months

Child, 2-5 years

Child, 6-12 years

Adolescent, 13-18 years

Adult, 19-44 years

Middle Age, 45-65 years

Aged, 65-80 years

Aged, 80 and over

Coverage (enter a range of years - e.g. 1994-current):

Do you want your results restricted to library holdings:

Yes

No

Do you need:

A list of a few relevant articles

A list of articles with my topic as a major focus

A comprehensive list of articles on my topic (may be <200 articles)

Reviews of the literature (with extensive bibliographies)

Maximum number of citations desired:

Please estimate the number of relevant articles published in your topics within the last three years:

Any additional comments:

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