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Tour Request - ACC Regional Simulation Center
Please complete the form to initiate a request for simulation rooms and skills lab space only.
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Email
*
Your email
Primary Contact Name
*
Your answer
Purpose of the tour:
*
Your answer
Type of visitor
*
Student (K - 12)
Prospective ACC Student
Community Member
Government Official
Business Leader
Prospective Donor
Academic Institution
Other:
Required
Total number of participants
*
Your answer
Date(s) requested: (MM/DD/YYYY)
*
Your answer
Time(s) requested:
*
Your answer
Anticipated equipment requested for demonstration: (Check all that apply)
*
Manikin
Task Trainer
Electronic Health Record
A/V System
Other:
Required
Will a classroom be required?
*
Yes
No
Required
Is there a plan for external media coverage?
*
Yes
No
Required
Please enter any notes or comments to help with planning this request.
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