• ATSSL Booking Request Form

    This form should take 5-10 minutes to complete.

  • The ATSSL at the University of Calgary collects and protects your personal information in compliance with Alberta’s POPA and institutional privacy guidelines. If you have any questions about the collection, use, or disclosure of this information, please contact: George Mulvey, ATSSL Manager (gmulvey@ucalgary.ca).

  • Which of the following best describes this event?*
  • Format: (000) 000-0000.
  • Are you the Educational Lead for this Event?*
  • Are you the principal investigator (PI) for this project?
  • What is your primary affiliation?*
  • Which UCalgary department does this event represent?*
  • Which ATSSL Resource are you interested in booking?
  • 0/255
  • 0/255
  • Please select all CanMEDS competencies that will be assessed:
  • Which specific ATSSL space are you looking to reserve?*
  • Do you require a classroom in addition to your specific ATSSL space request?
  • Will this event be catered?
  • 0/255
  • 0/255
  • Do you require any equipment?*
  • 0/255
  • Is any industry providing support for this event (e.g., equipment, instruments, or resources)?*
  • 0/255
  • 0/255
  • Please confirm if you require cadaveric specimens. By answering Yes, I acknowledge and affirm that the learners who will be using this educational material and engaging in skill practice activities are entirely within their legal scope of practice.*
  • Which of the following best describes the session you would like to book ATSSL resources/services for?*
  • How many sessions would you like to book?
  • Preferred End Date:
     / /
    4 digit year, 2 digit month, 2 digit day
  • Preferred Start Date:*
     / /
    4 digit year, 2 digit month, 2 digit day
  • Preferred Start Time: *
  • Preferred End Time:*
  • 0/255
  • Preferred Start Date #2:*
     / /
    4 digit year, 2 digit month, 2 digit day
  • Preferred start time for Date #2:*
  • Preferred end time for Date #2:*
  • Preferred Start Date #3:*
     / /
    4 digit year, 2 digit month, 2 digit day
  • Preferred start time for Date #3:*
  • Preferred end time for Date #3:*
  • Preferred Start Date #4:*
     / /
    4 digit year, 2 digit month, 2 digit day
  • Preferred start time for Date #4:*
  • Preferred end time for Date #4:*
  • Preferred Start Date #5:*
     / /
    4 digit year, 2 digit month, 2 digit day
  • Preferred start time for Date #5:*
  • Preferred end time for Date #5:*
  • Preferred pickup date:
     / /
    2 digit month, 2 digit day, 4 digit year
  • Preferred return date:
     / /
    2 digit month, 2 digit day, 4 digit year
  • What is the primary affiliation(s) of the learners?*
  • Will you require an estimate for the fees associated with this request?
  • Please indicate which of the following will be used for covering any costs incurred by your request?*
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof

  • Conflict of Interest (COI)
    In accordance with the ATSSL Operating Standard for Conflicts of Interest and the University of Calgary’s Code of Conduct, all academic staff members, clinical and adjunct appointees, employees, and non-employees/non-appointees who are involved in the design or implementation of simulation or educational activities in the ATSSL are responsible for ensuring that their use of the ATSSL does not result in a perceived or actual conflict of interest.

    Prior to using the ATSSL, academic staff, employees, and clinical/adjunct appointees (those subject to the University Code of Conduct) and/or individuals/organizations who do not have an employment or appointment relationship with the University of Calgary but who are involved in the design or implementation of simulation or educational activities in the ATSSL must attest to the following:

  • Should be Empty: