Healthnet: Connecticut Consumer Health Information Network

Contact
Form

Healthnet Home
UCHC Library
Search
Index
Help



Please use this form for comments or to inform us of any changes in information. You may also email us at Healthnet@uchc.edu.

This form works best with IE 5 or above and Netscape 6 or above. If you have difficulty submitting your information, please email it to Healthnet@uchc.edu. Thank you.

First Name:
Last Name:
Institution:
Address 1:
Address 2:
Town:
State:
ZIP Code:
E-mail Address:
Telephone:
(Please include area code)
Comments:


I would like to receive e-mail notifications of the Healthnet newsletter.

I would like to continue to receive a print copy of the Healthnet newsletter.*
*Note - For Connecticut health sciences libraries and out of state libraries - please submit a check in the amount of $10 made payable to "University of Connecticut Health Center Library" or you may indicate your EFTS Library ID# in the Comments box above and your account will be charged $10.
I would like to receive e-mail notifications of Healthnet programs.



Healthnet Home
UCHC Library
Search
Index
Help



UConn Health Center Home
Healthnet: Connecticut Consumer Health Information Network
Lyman Maynard Stowe Library
University of Connecticut Health Center
PO Box 4003 - 263 Farmington Avenue
Farmington, Connecticut 06034-4003

Email: Healthnet@uchc.edu

Copyright 1998 - 2003 All Rights Reserved.
The URL for this page is: http://library.uchc.edu /departm/hnet/forms/subform.html
Last Updated: February 26, 2008