Pagano Assistance Request Form - UNC Lineberger Cancer Network

Is the event cancer related? (Note that the UNC LinebergerCancer Network only supports cancer-related event(s):*

Since your event is NOT cancer related, please contact the School of Medicine Room Reservations/Scheduling for assistance.

General Information

Name of the primary contact (in the room) for this meeting:*

Name of Person Requesting Services:*

Email address:*

Mobile Phone Number:*

Date of Event:*

Start Time of Event:*

End Time of Event:*

Title of Event:*

Does your meeting include using Zoom (web conferencing)?*

Would you like for UNCLCN to schedule the Zoom meeting?*

Is there any other type of Zoom support that you might need?

Are there any remote participants?*

If “Yes” how are they joining?*

Which of the following options for remote participants will you need*

Please select the forms of support that you will need:*

I need an orientation of the room, and I will handle everything myself on the day of the event.
I need technical staff to be present during the start of the meeting
I will need UNCLCN to monitor my entire meeting — if "Yes," you must provide the meeting agenda
I want UNCLCN to test the call of the conference with the participant(s)
I will not need any additional support

Is there any other type of general support that you will need?

Only for non-PHI. Do you want UNCLCN to record this meeting? Please note that we do not record patient health information (PHI).

I want UNCLCN to record this meeting.
I want UNCLCN to send me the video link
I want the event to be live streamed (with a link for non-interactive participants — up to 1,000)