Scan and Deliver Request Form


  • UCHC faculty, staff, and students may use the form on this page to submit requests. After 25 requests, ILL + Scan and Deliver, FOAPAL coding or credit card must be provided.
  • UCHC patrons who wish to pay via cash or check, after 25 requests, ILL + Scan & Deliver, may print out and submit this form.
  • Non-UCHC patron information is available here.

Scan and Delivery Request Form for Health Center Faculty, Staff and Students

Library staff will access and send health-related journal articles from the UCHC Library collection QUICKLY and EFFICIENTLY. You may request OVERNIGHT service with delivery available the next day Monday through Thursday, or SAME DAY-RUSH service if the request is received by 2pm, Monday through Friday.

After 25 requests, ILL + Scan & Delivery charges are:

$3 $5



Name: *

  Tel.: *   Library Barcode #: *

UCHC Mail Code/mailing address:

E-mail: *

FOAPAL Coding:

If paying via MC or Visa, please call (860) 679-2940 with your information.



    Via email (PDF)
    I'll pick up the article(s) at the Library Circulation Desk
    Mail to the address given above.

IF WE DON'T HAVE IT : We'll get the article for you from another library. Charges may applyYes   No



Journal Title:

Volume:    Number:   Year:   Pages:

Author of article:

Title of article:

OR: Copy and paste from another document (such as PubMed) to this box:


The copyright law of the United States (Title 17, US Code) governs the making of photocopies or other reproductions of copyrighted material. Under certain conditions specified in the law, libraries and archives are authorized to furnish a photocopy or ot her reproduction. One of these specified conditions is that the photocopy or reproduction is not to be "used for any purpose other than private study, scholarship, or research." If a user makes a request for, or later uses, a photocopy or reproduction f or purposes in excess of "fair use," that user may be liable for copy-right infringement. This institution reserves the right to refuse to accept a copying order if, in its judgment, fulfillment of the order would involve violation of copyright law.

Before you send the form, make sure you have filled out all the fields with an * next to them, or the form will not be submitted. Also, please verify that the information you have provided is accurate before you submit the form.

I have read, and agree to abide by, the preceding Copyright Statement *

Circulation Department