Project Request Form More Project Request Form Please complete to begin the process for any list pulls, graphic design, email or printing needs. Submitted by:Name(Required) First Last Email AddressToday's Date MM slash DD slash YYYY Project Due Date MM slash DD slash YYYY Project Name(Be specific in the project name to assist with tracking, ex. Fellows Module II agenda, THA Conference Directional Signs, THARP 2025 Summer Board Book, etc.)Project DescriptionType of Request(Required)Artwork OnlyNew Basecamp ProjectExisting Basecamp ProjectPrint OnlyOtherIf "Other" is selected above, please describe.Project Code(Company, Fund, Department, Function, Project Code, Subproject Code)FormatEmail OnlyList Request OnlyPrint or CopyPrint and MailMailDistribution InformationDistribution List Codes AA – Admin Assistant – Other 1CAA – Admin Assistant to CEO 1CACEO – Associate CEO/Administrator 1CCHAIR – Chair of the Hospital Board 1CCO – Chief Compliance Officer 1CEDO – Chief Education Officer 1CEO – Chief Executive Officer 1CFM – Chief Facilities Manager 1CFO – Chief Financial Officer 1CHIM – Chief Health Information Management 1CHR – Chief Human Resources 1CIC – Chief Infection Control Officer 1CIO – Chief Information Officer 1CLO – Chief Legal Officer/General Counsel 1CMC – Chief Managed Care 1CMO – Chief Marketing/PR Officer 1CMM – Chief Materials/Purchasing Manager 1CNO – Chief Nursing Officer 1COO – Chief Operating Officer 1CPE – Chief Physician Officer 1CQA – Chief Quality/Risk Management 1CVP – Executive President/Vice President COMP – Compliance Staff DIS – Disaster Emergency Contact FIN – Financial/Bus Office Staff FDN – Foundation GOV – Government/Advocacy HR – HR Staff LEGAL – Legal Staff IT – IT Staff MPR – Marketing PR Staff QA – Quality/Risk Management Staff RN – Nursing Staff TST – Trustee Other If "Other" was selected, please specify here.If needing to include past attendees or other groups please specify here.Organizations Members Only Members and Non-Members All Hospitals, Systems and Divisions All Hospitals, No Systems and Divisions (Selection will be for all hospitals if nothing is checked)Bed Size 100 Beds or Less 101-200 Beds 201 or More Beds (Selection will be all bed sizes if nothing is checked)Geographic Classification Rural Urban Both Print Project DetailsPrint Project TypeBookletBrochureBusiness CardsFlyerName Badges/Name CardsPostcardPosterOtherIf "Other" was selected, please describe.Print InformationSize, Color or B&W, etc.Print QuantityAttach any relevant files Drop files here or Select files Max. file size: 20 MB, Max. files: 4. CAPTCHA