DATE OF REQUEST: -- mm/dd/yy                    NEED BY DATE: -- mm/dd/yy

In accordance with U.S.C. 3012, AR 40-2, AR 735-17, and AR 735-5, the personal information above is solicited to identify the person who requested the information for further identification of the search problem and for informing the requestor when the search is ready. Disclosure is voluntary; however, if an individual does not provide the requested information, the search cannot be delivered.

The questions below are designed to provide information needed to develop a bibliography responsive to YOUR need. Care in providing full information will determine the usefulness of the citation you receive.

PURPOSE OF SEARCH:

Patient care    Research        Paper           Other(specify)

DESCRIPTION OF SEARCH PROBLEM (2-3 sentences describing the subject matter of the search. Define any terms of special significance):

RELATED TERMS PERTINENT TO SEARCH:                    RELATED TERMS NOT TO BE SEARCHED:

AUTHORS (Individuals or companies known to be pertinent to the search problem):

CONSTRAINTS/LIMITS:

Language Time span to be searched # of citations desired Geographical limits

TYPES OF MATERIAL:

Articles Book reviews Conference papers Government documents Reports Dissertations         

Use this block to specify any constraints/limits:

Copyright © 2003 Evans Army Community Hospital. All rights reserved. Revised: 08/14/09