Reference Request Form
CTHL-PCMC-RRF2 I 03012021 Rev. 0

PRIVACY STATEMENT: The PCMC Healthcare Library is committed to protect and respect your personal data privacy. Personal information collected like name and contact number will be used solely for documentation and processing purposes and shall not be shared with any parties. Only PCMC Medical Librarians have access to the personal information. These data will be stored in the database/file for one (1) year after information requests are acted upon after which physical record shall be disposed in compliance to the National Archives of the Philippines Act of 2007.
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Email *
Date of Request: *
MM
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DD
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YYYY
Time Requested: *
Time
:
Time Served:
Time
:
Name of Client (Last Name, First Name, Middle Initial) *
Client's Local Number: *
Department/Unit: *
Position/Designation: *
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