COMMUNITY HEALTH

C-O-N-N-E-C-T-I-O-N-S

Reserve a Book or Video

CHC offers this library service without cost to those in the following Pennsylvania counties: Armstrong, Beaver, Butler, Clarion, Crawford, Indiana, Lawrence, Mercer and Venango.

To reserve a book or video, please fill out the following form and submit the information to us. After submitting this form, you will be contacted by CHC for delivery details.

All items are due 30 days after delivery.
Unreserved items may be renewed for an additional 30 days by phoning our offices at: 724-283-0990.
Up to two resources per person may be borrowed at one time.
All items not returned within 30 days of due date will be invoiced to the borrower for cost of replacement plus shipping and handling charges.

Please provide the following contact information:

Name:

Required

Title:

Required

Other:

Agency:

Required

Street Address:

Required

Address (cont.)

City:

Required

State:

Required

Zip/Postal Code:

Required

County:

Required

Work Phone:

(Use this format: 777-555-1212)

Home Phone:

(Use this format: 777-555-1212)

FAX:

(Use this format: 777-555-1212)

E-mail:

Comments:

Media You Would Like to Borrow:

You may borrow up to two (2) resources.

Resource 1:

Media Type:

Required

Book Pamphlet Handbook Binder
Video (Select type) VHS DVD CD

Title:

Required

Resource 2:

Media Type:

Book Pamphlet Handbook Binder
Video (Select type) VHS DVD CD

Title:

Home Services Newsletter FAQ Ask the HCQU Testimonials Links Contact Us

Training: Training Schedule Special Events Web Based Training Surveys: Survey 1 Survey 2 Survey 3

Resources: Media Library Alerts HCSIS Services and Support Directory Dental Providers Download Forms

This web was Spun by

The Web Spinner

724.283.0990

info@hcqu.org