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All activities and submissions are logged and your IP address {
3.239.129.52
} is stored to the log.
Your Name
Phone / Ext
Service
Clinical Engineering
Priority
STAT
2 Hours
Same Business Day
Next Business Day
Next 7 Days
Next 14 Days
Next 30 Days
Patient Incident
Ref #
Department
select
Subject
Equipment - Request
Department - Request
Description
ULH
UNIVERSITY OF LOUISVILLE MEDICAL CENTER
530 SOUTH JACKSON STREET
LOUISVILLE, KY 40202
Request
Sample title
Success Notice
Are you sure you want to create an immediate request after on-site hours?
WARNING: Creating this request will notify personnel that are not onsite.
Facility:
n/a
Service:
n/a
On-Site Time:
n/a
{1}
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##LOC[OK]##
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{1}
##LOC[OK]##
{1}
##LOC[OK]##
##LOC[Cancel]##
{1}
##LOC[OK]##
##LOC[Cancel]##