University of Colorado Cancer Center

Shared Resource

Equipment Request Form

This form is to be used to request resources of any kind from the CU Cancer Center to be used toward the procurement of equipment.


Prior to filling out this form, you will need the following:

  • Quote for new equipment
  • Justification for equipment need
  • Funding plan for new equipment - equipment, installation, training, and service disruption
  • (New Equipment Only) Member survey to justify member interest in equipment
  • (Replacement Equipment) Use metrics when applicable


Please note Cancer Center Administration will need at least 6-8 weeks lead time to review and approve the request.

 
 
 
 
 
 
 
 

 

Justification

 
 

Why does your SR need this equipment? IE improved efficiency/throughput, higher quality, old machine retired, etc.

 
 

 

Equipment

Please only provide the cost of the equipment in this section - you will be able to report on service contract, installation, and other costs associated with the equipment below.

 

What is the total cost of only the equipment?

 
 

 

Service Contracts and Data Analysis

 
 
 
 
 
 
 

 

Installation

 
 
 

 

Training and Service Disruption

 
 
 
 
 

 

Impact on other Shared Resources

 
 

Please attach as a single pdf the following information: preliminary quote(s) for the equipment; outline of a business plan to show the estimated costs (reagents, service contracts, staffing) and rates; survey results to demonstrate cancer center member interest and potential to use the proposed equipment; any additional information you feel is necessary to support your request.

Drop your files here