Schedule Request Form

Email address

Facilator name

Date of simulation

Start time

End time

Number of students

What time does the room need to be available to you for setup?

Simulation operator name

How many standardized patients do you need?

Standardized patient arrival time

Standardized patient departure time

Please list all non-disposable equipment needed (e.g. ventilator, glucometer, etc.)

CentraHealth.com does not provide medical advice, diagnosis or treatment recommendations. This website is not a substitute for your doctor or other health care professional's care. The material on this site is for informational purposes only.