Tour Request Form

To arrange a tour of the UI Health Care Tour, please complete this entire form and submit it online. We will do our best to schedule your requested sites, but we cannot guarantee the availability of every location or date available.

Contact Person Contact Person Address City State

Zip Email (required) Best time to contact Local Newspaper

Class/Group Information Group Name Age Range of Students Number of Students Number of Chaperones Total Visitors (20 Max) Disability Accomodations Groups previous science classes/experience what Does your group want to learn on the tour?

Tour Date

No tours on Fridays, all tours between September 22, 2998 - May 29, 2010.

First Choice
Second Choice
Third Choice
Arrival Time*
Departure Time

*Tours last for a maximum of 4 hours, including lunch.

Preferred Sites to Visit

Please list the sites students would like to visit during the tour, in order of preference. Sites listed are not guaranteed to be on the tour.

Site 1
Site 2
Site 3
Site 4
Site 5
Site 6
Site 7
Site 8