Resource Request Form

To request resources for your student group/organization, classroom, or residence hall, please fill out and submit the form below. You will be contacted by a Campus Health Peer Health Advocate approximately two business days after submitting your request to confirm your submission.

Contact to ask questions:Dana Carpenter, Program Coordinator at dlcarp02@louisville.edu or 852-6784 or Email Health Advocates

Today's Date

/ /

Person Requesting Resources

Name (Required)

Email (Required)

Phone Number (Required)

Organization

Position (Required)

Check all that apply.

RSA officer/member

RSO officer/member

Faculty

Other

Other Position

Resources (Required)

Choose the materials that you would like to request from the dropdown. Anything with an asterisk (*): 3 maximum; more available upon making a Program Request.

Item Quantity (Required)

If Brochures/Educational Materials, what topic would you like these for?

Campus (Required)

Belknap/HSC

Belknap
HSC

How will these resources be used? (Required)

Date/Time Needed (Required)

/ /

Submit this form by clicking submit button provided or
to contact by phone: 852-5429

You will receive confirmation or request for more info in 2-3 business days.

THANK YOU for contributing to a campus community that values health, vitality, resilience and academic excellence!

Personal tools

Resource Request Form

Person Requesting Resources

Document Actions

Personal tools