PHOTOCOPY REQUEST FORM
FOR HEALTH CENTER
FACULTY, STAFF AND STUDENTS
Return to:
ILL Department - UCHC Library; PO Box 4003; Farmington, CT 06034-4003
UCHC Mail Code 4003
Fax: 860-679-4046
Library staff will photocopy health-related journal articles from the UCHC Library collection QUICKLY
and EFFICIENTLY on a prepaid basis. You may request OVERNIGHT
service with photocopies available the next day after this form
is submitted, or SAME DAY-RUSH service if the request is received
by 2pm, Monday through Friday.
OVERNIGHT SERVICE ($5)___ SAME-DAY-RUSH SERVICE ($7)___
PAYMENT :
Check enclosed payable to UCHC Library __
Department FRS Coding:________________________________
Master Card / Visa Account (min. $5) Expiration Date
________________________________________________________ ___/___
Name_____________________________________Tel._____________________
UCHC Mail Code/mailing address_______________________________________
__________________________________________________________________
DELIVERY: ___I'll pick up the article(s)
at the Library Circulation Desk
___Mail to me at the UCHC
or mailing address given above.
___PDF via Internet (when possible), e-mail address required
IF WE DON'T HAVE IT : We'll get the article for you from
another library. This Interlibrary
Loan usually takes 2 working days and costs $10. ___yes ___no
ARTICLE REQUESTED
Journal Title:_______________________________________________________
Volume_________Number____________Year____________ Pages__________
Author of article___________________________________________
Title of article______________________________________________________
NOTICE
WARNING CONCERNING COPYRIGHT RESTRICTIONS
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 other 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 for 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.
LIBRARY STAFF USE ONLY
DATE RECEIVED____________ DATE COPIED_____________
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