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Reserve Book Request Form

To submit an entire book for DUMC Library Reserves, please complete and submit the form below via the Web. Completed Reserve Book Request Forms may also be attached to personal copies of books, which should be submitted in person or via mail (Duke Medical Center Library, DUMC Box 3702, Attention: Suzanne Jessup). Forms submitted over the Web will be retrieved once daily, Tuesday through Saturday. If you have additional questions, please contact Suzanne Jessup at (919) 660-1100 or jessu001@mc.duke.edu.

**Course & Instructor Information (* below indicates required field)**
To submit multiple requests for the same course and instructor:
Use the back browser button to return to this page after submitting each request. All information will be retained for reuse.
Today's Date
Course Title*
Course Number*	Ex. MIC200
Term & Year*	Ex. Spring 2005
Maximum Enrollment*
Main Instructor* (ONE ONLY)
School & Department*
Instructor Duke Box # *
Instructor Phone/Pager*
Instructor Email*
Dates Needed on Reserve	through

If no removal date is provided, books will be removed from reserve at the end of the semester. DUMC Library books will be returned to the stacks. Instructors will be called at the phone/pager # above and asked to pick-up personal copies. If they are not picked up within one week of removal from reserve, they will be returned via mail to the Duke box # listed above.

**Book Information**
Call Number
Author/Editor*
Book Title*
Publication Year & Edition*
Want a later edition if one is available?*	Yes No