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Simulation, Experiential Learning, and Training Center

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SET Center Scheduling

Home / SET Center Scheduling / SET High Fidelity Equipment Request Form

SET High Fidelity Equipment Request Form

Please visit the聽before submitting your requests.

Sim Equipment Request Form

To reserve simulation equipment or request further information about equipment needs, please complete the following form. We will respond to your request shortly. Please note that no reservations are added to our calendar until you have received confirmation.

Contact Information
Primary Contact Name*
Phone Number*
Additional Phone Number
Email Address*
Group/Department Name
Equipment Request (Please Select All That Apply.)*
- Laerdal 3G Adult - Frank
- Laerdal ALS Man - Remy
- Laerdal Sim Jr - Peter
- Laerdal Sim Jr - Bruce
- Laerdal Sim Baby - Alice
- Laerdal Sim Baby - Benjamin
- Laerdal Sim NewB - Schrodinger
- Laerdal Sim NewB - Janet
- Laerdal Sim Premie - Pym
- Laerdal 3G Adult - Anesthesiology - Simon
- Laerdal SonoSim - Ultrasound Simulator
- Sonosite S-nerve - Ultrasound Machine
- GE LogiQ V2 - Ultrasound Machine 1
- GE LogiQ V2 - Ultrasound Machine 2
- GE LogiQ V2 - Ultrasound Machine 3
- GE LogiQ V2 - Ultrasound Machine 4
- GE LogiQ V2 - Ultrasound Machine 5
- GE LogiQ e - Ultrasound Machine 6
- Laerdal 3G Adult - Robin - SOM Only
- Laerdal 3G Adult - Alex - SOM Only
- Laerdal 3G Adult - Sam - SOM Only
- Other item (task trainer, CPR manikin, etc.)
Will You Need A Sim Tech For This Session?*
Please note that sim tech availability is not guaranteed.
- Yes
- No
I Understand The Confirmed Times Will Include 30 Minutes Before And After The Requested Times*
- Yes
Start Date*
Month
Day
Year
Start Time*

: Hours

Minutes

AM/PM
End Date*
Month
Day
Year
End Time*

: Hours

Minutes

AM/PM
Is This A Recurring Event? If So, Please List Additional Dates:
Please Give A Brief Description And Location Of Your Event (Include All Pertinent Equipment And/Or Adapters You Will Use):*
Location: Brief Description: Additional Tool/Adapter Needs:
Additional Comments/Requests:

Δ

For additional information, please email jeff_mcqueen@med.unc.edu or contact the CSPSC at (919)843-0521.

SET Center Scheduling

SET Center Calendar
SET Center Scheduling Form
SET High Fidelity Equipment Request Form

Contact

Simulation, Experential Learning, and Training Center
Roper Hall Suite 4210
150 Medical Drive, CB #7529
Chapel Hill, NC 27599

Telephone:聽(919) 843-5924

Quick links

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