ILC Change Request Form
This form can be used for changes to course time or date, addition or subtraction of rooms or resources, and alterations to course set up/take down time for events in the Immersive Learning Center (ILC).
All programs must be finalized two weeks prior to the scheduled program date. We cannot guarantee that change requests made with less than two weeks' notice will be accommodated.
PLEASE NOTE: In observance of the School of Medicine's mandatory Winter Closure, the Immersive Learning Center and Medscheduler will be closed Saturday, December 23, 2017 through Sunday, January 7, 2018. All requests received during that time will be attended to on or after January 8, 2018.
This number is located on the booking confirmation form that was sent to the requestor and lead faculty (e.g. 2016-ABCDEF)
Currently scheduled date that you would like to make changes to
i.e. please enter the date (dd/mm/yy) that you would like to make changes to. If these changes apply to multiple dates, list every date affected. If you are adding an additional date, please enter "Add date".
Additional dates to change
If you would like to cancel any dates, these must be submitted separately through the cancellation form:
New or added course date
Enter your new date request (MM/DD/YYYY), followed by the start and finish time. If you are only changing the rooms, resources or set up/take down time, enter N/A
Additional new dates
Enter additional new date request/s (MM/DD/YYYY), followed by the start and finish time
Describe the change
Enter any relevant additional information about the change
Reason for change
Other (please describe reason in comments section)
Booked in error
Faculty not available
Change to schedule
Low show (office use only)
Does your course require or involve one or more Standardized Patient (SP) actors, nurses, or contingent staff members?
Note: As per our SP policy, if an event is being cancelled within 14 days of the scheduled date, all SPs must be paid in full for the hours that they were originally booked
Send me a copy of my responses
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