Literature Search Request Form

Date of request:
Date request filed:
Date needed (Searches usually completed within 24 hours from time of request):
Name of requester:
Telephone #:
E-Mail:
Beeper #:
Fax #:
Department:
Address
If clinical in nature we prefer the request in form of a PICO question. Describe subject matter for which search is to be conducted. PLEASE BE SPECIFIC. Define terms that have meaning in your request. State points NOT to be included. Please do not abbreviate. List current, relevant citations and terminology and any other general requirements for the requested information. Examples of general requirements could be peer-reviewed, from nursing journals only, review articles only, authored by nurses, information from relevant books, etc.
Purpose of search:
  • Patient Care
  • Job-related research
  • Teaching/presentation
  • Research for publication
  • Course assignment
Please specify if applicable:
Language(s)
Age group(s)
Animals (specify)
Geographic area(s)
General interest
Databases to search:
  • Medline/PubMed
  • CINAHL
  • Cochrane
Years to be searched:
  • 5-yr or current file
  • 10-yr backfile
  • 15-yr backfile
  • 20-yr backfile
  • 30-yr backfile
  • Other than above
In lieu of my signature, by submitting this form, I attest that the information submitted is accurate and correct.
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