Please do not use this link to submit Copyright Approvals. Please see the new link below to submit.

Requestor Email

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Requestor Department*

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Description of Copyrighted Materials Requiring Approval*

Original Source of Copyrighted Material*

Written Approval Obtained from Original Source?*

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Name of Medical or Staff Leader Authorizing this Request*

Examples include medical directors, vice chairs, unit directors, associate/chief officers, etc.

Medical or Staff Leader Email*

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