Room 2503 CVC (Patient Learning Lab): Register for Room Access

1. Where do you work (building)?
2. Why are you requesting access to this room?
3. Name of person requesting access
4. At what email address would you like to be contacted?
5. At what phone number/pager would you like to be contacted?
6. How many weeks/months will you need access to breast-pumping space?
(please provide your approximate start & end dates as well)
7. What breast-pump do you plan to use?
8. What shift do you work?
9. How many days/week do you work? Are you full time/part time?
10. Thank you for completing this registration form. Once you submit the registration, please call 734-232-4120 to schedule a time to use the room and get the key code to enter. You can leave a voicemail.

Since the room is a multi-purpose room, all users are asked to schedule (this is vital during day-time hours); no-shows or ad-hoc users may lose access to the room. Thank you.

Once you sign up and receive the access code, you will be added to a "read only" email schedule that will allow you to view room reservations.
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