Contact Us - ITS Service Desk

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FCH Requests

FCH Items *

Web Address * Please provide the url to the page you are entering a ticket about

Principal Investigator Information

PI First Name *

PI Last Name *

Type of Assistance Needed *

Are you a Penn Affiliate? *

Other Affiliate

Other Ranking

Primary Contact Information

First Name If different than P.I.

Last Name If different than P.I.

Phone Number *

Email Address * primary contact email

What is your preferred method of communication?

Project Information

Start Date *

End Date *

Project Title *

Project Acronym

Most urgent deadline is *

Please provide additional details. A structured abstract with project aims is preferred. *

Please specify the project type below (Select one)

Statistical or Data Management Consultation / Guest lecture request (No analysis required)

Data Entry / Management / Analysis of existing data

Has All Data Been Entered Electronically

Approximate Number of Data Records

Pilot Data Analysis

Do you need us to write an analysis plan?

Do you need us to generate a power analysis and summary?

Funding Available for Consultation / Data Analysis for Grant Development

Please Specify

Grant proposal with submission deadline *

Specific Aim of the Grant

Date of Submission

Project Start Date

Proposed Sponsor

Please Specify Proposed Sponsor

BHS Items *

Categories *

Course Number & Term (Pls use format: NURS XXX-XXX 2020C, enter N/A if no course #) *

Report Name *

Internal/External Submission *

Report Description (Please be specific in dates/terms/years needed) *

Business Reason/Objective - Who is the intended audience for the information *

Have you requested this report previously? *

Deadline/Timeline to complete the report *

Can you provide an existing report, template or documentation? *

Priority *

Room Requests

Events/Setups

Operations Support - in house

Access (PennCard)

Cafe

Housekeeping

Other

Maintenance Issues (FRES)

Name *

Email *

Which department do you need assistance from? *

The Enterprise Infrastructure Services group provides the implementation, operation and support of the School’s physical and cloud infrastructures, the maintenance and support of Nursing provided enterprise applications, local support for all university provided applications, and enterprise data reporting and analysis.

Subject *

Category *

Affiliation Type Please specify the affiliation type that you would like created

Message *

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