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Surgical Skills Lab

SS LAB

SS LAB
Forms and Documents

Orthopaedics Department

Contact Information
Robert Ullery, MS, ATC
Orthopaedics/Sports Medicine
Phone: 859-218-3061
Fax: 859-257-8696
Email: rullery@uky.edu


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Lab Request Form

Event Sponsor:

Event/Function Title:

Please enter a contact e-mail:

Event Description/Details:

Choices of Date(s) for the Event:




Anticipated number of attendees/participants:

Lab rental amount requested
Full lab (5 stations + 1 Instructor's station)
Half lab (up to 3 stations)
Per station:
Number of Stations desired IF you selected "Per Station" Above:
1     2     3     4     5

Lab rental time reqested
Full day
Half day

Equipment/supply requests of items desired to be provided:

Instrumentation:
(We provide soft tissue, basic shoulder/hand/elbow/knee sets.)

Specimens:
If you are requesting specimens, you MUST fill out the Specimen Request Letter.

Scrubs:
Storage:


Items for event that will be provided/brought/shipped ahead of time or delivered by the event sponsor:

 

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Clinical Questions: (859) 257-1000 · College of Medicine Questions: (859) 323-6582
Page last updated Wednesday, May 27, 2009