CLINICAL STUDIES TECHNICIAN REQUEST
TEACHING AND RESEARCH
DATE SUBMITTED
TECHNICIAN REQUIRED
(AHT, Stats or Laboratory Tech)
REQUISITIONER: PHONE EXT.
Date(s) required
Time(s) required
Purpose of Request:
Research Project/ Course #
(include AUP#)
Billing Code:
DATE APPROVED and returned to requisitioner
TECH SIGNATURE
AHT: Mandy Hathway and Nicole Kudo
Stats: Gabrielle Monteith
Lab: Michelle Beaudoin-Kimble
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