Change Request Form

Complete this form if changes are needed to an existing reservation.

Section 1: Contact Information
With area code. No dashes.
With area code. No dashes.
FDM Billing Information
Section 2: Activity Information
Section 3: Sponsor/Participants Information
Check all that apply
Section 4: Activity Schedule
Activity 1
Activity 2
Activity 3
Activity 4
Activity 5
Section 5: Changes Requested
Every effort will be given to reserve the rooms requested; however, the MUSC Healthcare Simulation Center may substitute a comparable room if necessary due to scheduling conflicts.
Section 6: Special Instructions and/or Comments