This reservation involves demonstration and/or mimics a clinical scenario. Simulation is defined as the use of tools, devices, and/or the environment to mimic a particular aspect of clinical care.

Internal requests will book Sim Center rooms through EHS Outlook account.
All requests should include the exact title of the event (i.e., Acute Care ARD, Post-Partum Hemorrhage).
All dates are reserved as tentative until the Reservation Request Form has been completed with an agenda.
The event coordinator will be responsible for resetting all rooms reserved for the event.
Type of Request 

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* 1. Internal-Erlanger staff

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* 2. External- Outside Facilities

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* 3. Tours

Participants/Learners

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* 4. Staff

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* 5. Select the space(s) that will be needed:

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* 6. Coordinator

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* 8. Phone 

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* 9. Organization

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* 10. Will the event be held in the Simulation Lab?

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* 11. Title of Event 

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* 12. Select Departmental Staff Training Options if Applicable

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* 13. Lead Educator/Facilitator: 

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* 15. Objectives of Simulation

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* 16. Number of Participants

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* 17. Requested Date(s) of Non-simulation events
(For each date give Month/Day/Year):

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* 18. Expected Start Time 

Time

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* 19. Expected Stop Time

Time

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* 20. Expected Set-Up Time: 

Time

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* 21. Hands-on/Simulation Activities (please list) 

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* 22. Hours of Engagement per Participant:

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* 23. Simulation Staff Needs:

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* 24. Standardized Patient Participants

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* 25. Upload your Simulation Event Agenda

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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