Request an Equipment Loan

Request an Equipment Loan
Please submit this form at least one month before your preferred date. However, if you are on a shorter timeframe, please submit the form and we'll do our best to work with you.

For additional information about our resources, please refer to our Simulation Resource Catalog.

Please note: Equipment loans are at the discretion of the Simulation Core. Human Patient Simulators, Surgical Simulators, and other advanced trainers must be used in our facilities.

Note: Human Patient Simulators, Surgical Simulators, and other advanced trainers must be used in our facilities. Please note that a Simulation Event Request must be submitted to reserve those devices for use in simulation facilities.
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Role
School / Department / Organization
If you are a student group, please identify your faculty sponsor
Faculty sponsor email
example@example.com
Administrator for billing
Activity name
Activity Location
Pickup date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Return date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Equipment and supplies requested
Other details
By submitting this form
Please verify that you are human
Should be Empty: