Southwest Washington Medical Center



 
 

Library Interlibrary Information Request Form

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INTERLIBRARY BOOK REQUEST

Please allow at least ten business days for us to fulfill your request.

* Indicates required information
First Name * 
Last Name * 
Telephone or hospital extension * 
Pager 
Email Address 
Fax number 
What is the best method to contact you if we have questions? (Please provide the appropriate contact information) * 



Date this item is needed (normal turn-around is ten business days.)    (mm/dd/yyyy)
Department/Clinic 
Mailing Address 1 
Street Address 2 
City 
State 

If Other, please specify:

Zip 
Job Title * 







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Please provide as much information about your request as possible. 
Book Title * 
ISBN 
Unique Identifier 
Author/Editor 
Edition 
Pages/Chapter 
Publication Year 
Would a different edition still be useful * 
Any other pertinent information 
Where did you find this book? * 


If Other, please specify: