Database Search Request Form

*Required Fields ( Privacy Statement ) Date: 5/22/2013

*Name: *Phone Number : *Center Number:
Date needed by:(mm/dd/yy) *Building Number: *Room Number :

(If an authorized signature is required for chargeback purposes, you will be contacted by Library staff.)

OUTPUT

Years: 1-2 years 5 years 10 years Other (indicate years)

Languages: English Only All

Abstracts? Yes No

Review Articles Only? Yes No

*Output Options: Printed (Phone to pick-up or Send in mail ) E-mail address:

Do you want an authorizing letter on Scientific Library letterhead? Yes No (for cited reference searches only)

Do you want an Alert (Regular Update) on this topic? Yes No

SUBJECT

*What is the subject of your search? (For an author search, please include first names and initials if available.)

Do you have any examples of pertinent articles on the subject? If so, please supply additional information.

How much information do you expect to find? Nothing 5-10 references 100 references 100+ references

LIBRARY USE ONLY

Date & Searcher Initials	Database Name & File Number	Code	Minutes Logged	# of Citations Retrieved	Charge	NOTES

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Database Search Request Form