CHIPS Tour Request
Thank you for your interest in touring the UTHSC Center for Healthcare Improvement and Patient Simulation (CHIPS). Please complete this form and a member of our staff will contact you within 2-3 business days to discuss your request. If you have questions, please call us at (901) 448-4530 or email simulate@uthsc.edu.
Name *
Your answer
Email address
Your answer
Organization *
Your answer
Department or Program
Your answer
Purpose - Please tell us what you hope to gain from this experience.
Your answer
Number of people in your tour
Your answer
How long should the tour last
Requested Date and Time (1st Choice)
Your answer
Requested Date and Time (2nd Choice)
Your answer
Comments or Special Requests
Your answer
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