New Simulation Activity Request Form

Please provide the following information to use the MUSC Healthcare Simulation Center for an approved activity. If your activity has not been approved, please complete an Initial Simulation Activity Development Form. This form must be completed in its entirety during the Simulation Activity Development process. There are required fields that must be completed. Please contact us at for assistance in completing the form, if needed.

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
Section 4: Activity Schedule
Activity 1
Activity 2
Activity 3
Activity 4
Activity 5
Section 5: Rooms Requested
Instructions: If this is an In Situ activity and a simulation room is not needed, complete the In Situ Request Form in addition to this form and skip remainder of this form.

Rooms EL203H,E203F, EL203A, EL200G, EL 200F, EL203E, EL203B have an auxiliary control room that is included with the room requests.

Note: 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: Scenarios

Section 7: Setup Requirements