This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

/^((0?[1-9])|([1-8][0-9])|(9[0-8]))[0-9]{3}$/

/^((29([-\/])02\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1\d|2[0-8])([-\/])(0[1-9]|1[012]))|((29|30)([-\/])(0[13-9]|1[012]))|(31([-\/])(0[13578]|1[02])))(\11|\15|\18)\d{4}))$/

/^((02([-\/])29\3(\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00)))|((((0[1-9]|1[012])([-\/])(0[1-9]|1\d|2[0-8]))|((0[13-9]|1[012])([-\/])(29|30))|((0[13578]|1[02])([-\/])31))(\11|\15|\19)\d{4}))$/

/^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31))))$/

/^(((\d{2}([13579][26]|[2468][048]|04|08)|(1600|2[048]00))([-\/])02(\6)29)|(\d{4}([-\/])((0[1-9]|1[012])(\9)(0[1-9]|1\d|2[0-8])|((0[13-9]|1[012])(\9)(29|30))|((0[13578]|1[02])(\9)31)))) (\d|[0-1]\d|[2][0-3]):[0-5]\d$/

/^(?!\.)((?!.*\.{2})[a-zA-Z0-9\u0080-\u02AF\u0300-\u07FF\u0900-\u18AF\u1900-\u1A1F\u1B00-\u1B7F\u1D00-\u1FFF\u20D0-\u214F\u2C00-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u319F\u31C0-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF!#$%&'*+\-/=?^_`{|}~\d]+)(\.[a-zA-Z0-9\u0080-\u02AF\u0300-\u07FF\u0900-\u18AF\u1900-\u1A1F\u1B00-\u1B7F\u1D00-\u1FFF\u20D0-\u214F\u2C00-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u319F\u31C0-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF!#$%&'*+\-/=?^_`{|}~\d]+)*@(?!\.)([a-zA-Z0-9\u0080-\u02AF\u0300-\u07FF\u0900-\u18AF\u1900-\u1A1F\u1B00-\u1B7F\u1D00-\u1FFF\u20D0-\u214F\u2C00-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u319F\u31C0-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF\-\.\d]+)((\.([a-zA-Z\u0080-\u02AF\u0300-\u07FF\u0900-\u18AF\u1900-\u1A1F\u1B00-\u1B7F\u1D00-\u1FFF\u20D0-\u214F\u2C00-\u2DDF\u2F00-\u2FDF\u2FF0-\u2FFF\u3040-\u319F\u31C0-\uA4CF\uA700-\uA71F\uA800-\uA82F\uA840-\uA87F\uAC00-\uD7AF\uF900-\uFAFF]){2,63})+)$/i

/^[-+]?\b\d+\b$/

/^[a-z]+$/i

/^\d{10}$/

/^[a-z0-9-_]+$/i

/^[-+]?[0-9]*\.?[0-9]+([eE][-+]?[0-9]+)?$/

/^-?\d+,\d$/

/^-?\d+\.\d$/

/^-?\d+,\d{2}$/

/^-?\d+\.\d{2}$/

/^-?\d+,\d{3}$/

/^-?\d+\.\d{3}$/

/^-?\d+,\d{4}$/

/^-?\d+\.\d{4}$/

/^[-+]?[0-9]*,?[0-9]+([eE][-+]?[0-9]+)?$/

/^($0[2-8]$|0[2-8])\s*\d{4}\s*\d{4}$/

/^(?:$?([2-9]0[1-9]|[2-9]1[02-9]|[2-9][2-9][0-9]|800|811)$?)\s*(?:[.-]\s*)?([0-9]{3})\s*(?:[.-]\s*)?([0-9]{4})(?:\s*(?:#|x\.?|ext\.?|extension)\s*(\d+))?$/

/^((((\+44|0044)\s?\d{4}|$?0\d{4}$?)\s?\d{3}\s?\d{3})|(((\+44|0044)\s?\d{3}|$?0\d{3}$?)\s?\d{3}\s?\d{4})|(((\+44|0044)\s?\d{2}|$?0\d{2}$?)\s?\d{4}\s?\d{4}))(\s?\#(\d{4}|\d{3}))?$/

/^\d{4}$/

/^[ABCEGHJKLMNPRSTVXY]{1}\d{1}[A-Z]{1}\s*\d{1}[A-Z]{1}\d{1}$/i

/^(0[1-9]|[1-9]\d)\d{3}$/

/^\d{3}-\d\d-\d{4}$/

/^(\d|[01]\d|(2[0-3]))(:[0-5]\d){2}$/

/^([0-9]|[0-1][0-9]|[2][0-3]):([0-5][0-9])$/

/^[0-5]\d:[0-5]\d$/

/^[0-9]{4,9}$/

/^\d{5}(-\d{4})?$/

Jqtp8Cevszyp8Kuk6NCkXDf7v4Wep2aRoos8W2PABrsaZA4TrinqxLqghfxpprY576VBntSYa92WbPDMbhQxb97PnC4o5xnvCFh3BddZ

CTSI Room Reservation Request Form

Returning?

A A A

Please use this form to submit a reservation request for the Consultation Office (710M), Conference Room (710N) or the Research Training Center (Rooms 710 Q-R). We will respond to all requests within 24 hours. If you do not hear from us within 24 hours, please call the CTSI main line at 305-243-5096. Please note that submitting a request does not guarantee availability. However, we will do our best to accommodate your request.

Thank you!

Event Full Title

* must provide value

Event Type

* must provide value

Event Description

Expand

Please select the room preference.

* must provide value

CTSI Consultation Office 710M

CTSI Conference Room 710N

CTSI Training Center Room 710Q-R

reset

Primary Department /Division/Center

* must provide value

Expected head count for event

* must provide value

Room configuration preferred

* must provide value

A - one large room reservation (capacity 25 people - both sides of the research training center, adhering to COVID policies)

B - one small room reservation (capacity 12-13 - one side of the research training center, adhering to COVID policies)

C - two smaller rooms for simultaneous reservations (capacity 12-13 on each side of the research training center. Both rooms adhering to COVID policies)

D - conference room (capacity 8 - seating adhering to COVID policies)

reset

Will you need Zoom virtual meeting or use audiovisual equipment?
Meeting organizer is responsible for reaching out to CTSI to be trained on AV equipment at least one day prior to event.

* must provide value

Yes

reset

Will there be any external speakers, instructors or attendees other than UM participants?

* must provide value

Yes

reset

Please review and adhere to the latest University of Miami COVID-19 guidelines related to events with external speakers or attendees.
https://coronavirus.miami.edu/additional-resources/meeting-and-event-guidance/index.html

Will you be serving food for this event?

* must provide value

Yes

reset

Please provide the name of person responsible for food or designated to receive the catering for this meeting/event.

* must provide value

Please provide the cellphone number of person responsible for food or designated to receive the catering for this meeting/event.

* must provide value

Is your event a one-time only event or is it a recurring event?

* must provide value

One-time event (Use this option for a 1-day event or for ad hoc repeats e.g. 2-day event, 3-day event, etc.)

Recurring weekly event (Use this option for events that repeat on the same day and time every week)

Recurring monthly event (Use this option for events that repeat on the same day and time every month)

Other

reset

If 'Other', please specify.

* must provide value

Select number of days for your event

* must provide value

1 day

2 days

3 days

4 days

5 days

reset

Event Date

* must provide value

Y-M-D

Event Start Time (include set up/pre-event time)

* must provide value

Event End Time (include clean up/post-event time)

* must provide value

Weekly Event Start Date

* must provide value

Y-M-D

Weekly Event End Date

* must provide value

Y-M-D

Weekly Event Start Time (include set up/pre-event time)

* must provide value

Weekly Event End Time (include clean up/post-event time)

* must provide value

Monthly Event Start Date

* must provide value

Y-M-D

Monthly Event End Date

* must provide value

Y-M-D

Monthly Event Start Time (include set up/pre-event time)

* must provide value

Monthly Event End Time (include clean up/post-event time)

* must provide value

Day 1 Event Date

* must provide value

Y-M-D

Day 1 Event Start Time (include set up/pre-event time)

* must provide value

Day 1 Event End Time (include clean up/post-event time)

* must provide value

Day 2 Event Date

* must provide value

Y-M-D

Day 2 Event Start Time (include set up/pre-event time)

* must provide value

Day 2 Event End Time (include clean up/post-event time)

* must provide value

Day 3 Event Date

* must provide value

Y-M-D

Day 3 Event Start Time (include set up/pre-event time)

* must provide value

Day 3 Event End Time (include clean up/post-event time)

* must provide value

Day 4 Event Date

* must provide value

Y-M-D

Day 4 Event Start Time (include set up/pre-event time)

* must provide value

Day 4 Event End Time (include clean up/post-event time)

* must provide value

Day 5 Event Date

* must provide value

Y-M-D

Day 5 Event Start Time (include set up/pre-event time)

* must provide value

Day 5 Event End Time (include clean up/post-event time)

* must provide value

Do you need any of the following:

Registration Table

Table for food/catering setup

Breakout Room

(Optional) Please upload event flyer, email or other document related to the event.

Upload file

Primary Contact Person Name

* must provide value

Primary Contact Person Phone Number

* must provide value

Primary Contact Person Email

* must provide value

Meeting Host Name

* must provide value

Meeting Host Cellphone Number

* must provide value

Please provide a valid non-GR Work Tag number
(A valid work tag/account number must be provided to reserve the room)

* must provide value

Date for which you are requesting the room.

* must provide value

Y-M-D

Select the time slot(s) for the selected day.

* must provide value

8:00 AM - 9:00 AM

8:30 AM - 9:30 AM

9:00 AM - 10:00 AM

9:30 AM - 10:30 AM

10:00 AM - 11:00 AM

10:30 AM - 11:30 AM

11:00 AM - 12:00 PM

11:30 AM - 12:30 PM

12:00 PM - 1:00 PM

12:30 PM - 1:30 PM

1:00 PM - 2:00 PM

1:30 PM - 2:30 PM

2:00 PM - 3:00 PM

2:30 PM - 3:30 PM

3:00 PM - 4:00 PM

3:30 PM - 4:30 PM

4:00 PM - 5:00 PM

4:30 PM - 5:30 PM

5:00 PM - 6:00 PM

5:30 PM - 6:30 PM

6:00 PM - 7:00 PM

For requesting a room for multiple days, please provide the additional dates and the times for which you need the room here.

Expand

Please review the attached CTSI Research Training Center Usage Guidelines.

Attachment:

CTSI Research Training Center Usage Guidelines_2021_May26.pdf

Acknowledgments:
Please check the following box confirming your acknowledgement.

* must provide value

I have reviewed the CTSI Research Training Center Usage Guidelines and agree to uphold the requirements listed within the guidelines. Additionally, I have reviewed the university's COVID-19 guidelines for events and have obtained the necessary permissions, if any, pertaining to those guidelines.

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.

CTSI Room Reservation Request Form

Contact Details

You have selected an option that triggers this survey to end right now.