Quick Links

School of Nursing Skills Lab Request Form

Contact Information

Last Name:
First Name:
Email Address:
Phone Number:	--
Institution:	UH-Victoria Wharton County Junior College Other entities Entity name:
Institution:

Meeting Information

Course/Brief Description:	(ABC 1234 format)
Number of People:
Requested Room(s):	Skills Lab 1 (BH 387) Skills Lab 2 (BH 389)
Requested Room(s):	Practice Room (BH 381) Health Assessment Rooms (BH 395A-D)
Requested Date:	// (MM/DD/YYYY)
Start Time:	: (HH:MM AM/PM)
End Time:	: (HH:MM AM/PM)
Additional Date(s):	Please list additional dates and times

Supply Infortmation

SUPPLIES:* Beds only

High fidelity manikins Low fidelity manikins Demonstration models Miscellaneous supplies

Specify programs/set up for HFM	Specify programs/set up for LFM	Specify demo models	Specify misc. supplies
* Requests missing details for specific manikin programs, demonstration models, or miscellaneous supplies cannot be processed. Please fill out the necessary text fields to ensure your request will get processed in a timely manner.

For cancelations and changes to the requested room, contact Chamal Reyes at 281.275.3315 / creyes@central.uh.edu

For cancelations and changes to the requested supplies, contact Joan Bauman at 281.275.3060 / baumanj@uhv.edu or Angela Willis at willisa@uhv.edu.