DNS Request Form:
Items with * are required.
First Name:
*
Last Name:
*
Title:
*
Department:
*
If Other, please specify:
Select from the List
Anxiety Clinic
Analytical Psychopharmacology
Auditorium
Audio-Visual
Behavioral Endocrinology
Behavioral Medicine
Biological Psychiatry
Biological Psychiatry
Biological Studies Unit
Biometrics
Biopsychology
Biostatistics
Business Office
Central Supply
Comparative Medical Science
Child Psychiatry
Columbia University
Comparative Medical Science
Communication Sciences
Civil Service Employees Assoc
Clinical and Behavioral Studies
Clinical and Genetic Epidemiology
Clinical Neurobiology
Clinical Psychobiology
Clinical Psychology
Clinical Psychopharmacology
Clinical Psychopharmacology
Clin and Gen Epidemiology
Clinical Psychopharmacology
DES
Developmental Psychobiology
Division of Clinical Psychobiology
DRAT
DRAT(Research Assessment and Training)
Epidem of Mental Disorders
Education and Training
Engineering
Environmental Science
Eating Disorders Clinic
Epidemiology of Brain Disorders
Epidemiology of Substance Abuse
Geriatrics and Gerontology
HIV Center
Human Resources (NYS)
Institutional Review Board
Library
Medical Genetics
Medical Records
Memory Disorder Clinic
Molecular Genetics
Neurobio and Behavior
Neuroscience
Nursing
Nutrition Service
Occupational Therapy
Personnel (CU)
Personnel (NYS)
Pharmacy
Photography Illustration
Public Psychiatry
Ocupa Ther or Rec Ther Room
Quality Assurance
Research Assessment and Training
Research Foundation(RFHM)
Safety
Schizophrenia Unit
Social Psychiatry
Social Service
Storeroom
Substance Use Research
Technology and Information Systems
Therapeutics
Washington Hts Commun Svc
Others
Other:
Building:
*
PI New
Kolb
PI Old
Floor:
*
Room:
*
Work Phone:
*
Email Address:
*
Universal Address
MAC Address:
*
Please fill in using this
format on the right.
Also known as the Hardware address
12 Hexadecimal Characters: 0-9, A-F only
MAC - Media Access Control
IP Address:
*
Jack Number:
*
Operation System:
*
Windows
Mac OS 10 or higher
Linux or Unix
Note and special Instructions: