Technology Request Form

This form should be filled out by College of Nursing faculty and staff seeking to bring new technology to the College. The form is a starting point for a conversation about the technology and the goals of adoption.

Requestor's Name*
Date of Request
Date Format: MM slash DD slash YYYY
Requestor's email*
Requestor's phone
Date Technology is needed (if unsure, please note)*
Technology Requested (ex. type of technology, vendor name, etc.)*
What process/problem will the new technology address?*