Interlibrary Loan Request Form

To request an article from a journal:

Title of journal: *

Author(s): *

Title of article: *

Year: *

Number/Part: *

Volume: *

Pages: *

To request a book or chapter from a book:

Title of chapter: *

Title of book: *

Author(s) *

Edition *

Publisher: *

Year published: *

ISBN: *

If the book above is lost I agree to pay the cost in full: *

I agree

British Library books must be collected in person from Rotherham Hospital Library. A £5 charge will be made for non-collection of British Library books *

I agree

We'll let you know when your item arrives.
Books will be held in the library for you to collect. Articles can be sent out to you (by post or email), or held for you to collect. Please specifiy your preference below. If we can't email your article to you we'll let you know and will hold it for you to collect.

Your details

Copyright & Data Declaration

Today's date: *

I certify that I have not previously been supplied with a copy of this item by you or any other library. I will not use the copy except for the purpose of private study, work or research for a non-commercial purpose and will not supply a copy of it to any other person. To the best of my knowledge no other person with whom I work or study has made or intends to make at this time a request for a photocopy of this item substantially for the same purpose. By submitting this request I understand that I shall be held liable for any infringement of copyright resulting from a false declaration

How we use your data *

I understand that the data I submit through this form will be held by the Library & Knowledge Service and by our web host Weebly in accordance with their respective privacy policies (https://www.trftlibraryknowledge.com/privacy-policy.html). Our Weebly service is hosted in the USA. Data submitted through our website is processed by Weebly, Inc. Whilst every care is taken by us to protect your data in the UK, the USA has its own Privacy Laws (Privacy Shield) and although some states are adopting GDPR regulations, this is not a statutory requirement. If you prefer not to submit your data in this way please contact the Library by phone or email; all our services can be accessed in this way.

Library staff use only

Due back: *

Notified *

Ret'd *

Rec'd from: *

Deadline *