The Ohio State University
Health Sciences/College of Medicine and Public Health
College of Medicine Web Information Provider Agreement Form
It is the policy of the College of Medicine and Public Health that pages on the College Web server are for the support of student services, academic and research programs. Commercial and personal contents will not be included in a College-supported site. 

_______________________________________________ ( please print Department or Group Name) has developed a new Internet (WWW) Home Page. I reviewed and approve of the content of this page. As an information provider for The Ohio State University College of Medicine Web server, I agree to accept the responsibility for web page content for the group (Department, Center, Division, or Program) designated above and to follow the Web policies and procedures of the College and University. 

Name of Information Provider: ________________________________________________ 

Address: _________________________________________________________________ 

Phone: ______________________________ Fax: _______________________________ 

E-mail: _________________________________________________________________ 


The new Home Page and its subpages will be: 
_____ Housed on the College's Web Server ( www.med.ohio-state.edu ) - OR 

_____ Located at the following URL (Uniform Resource Locator): 

           http:// __________________________________________________________ 

Department Chair's Authorization:
I ____________________________________ (please print ) have reviewed and approve of the content of this page.
Signature: ___________________________________________ Date: ____________ 
Chair's
Bldg # _______

Room # ______
Send completed form to:
Information Systems Office 
College of Medicine and Public Health (COM&PH) 

1068 Graves Hall 

333 W. 10th Avenue 

CAMPUS 

Reviewed by COM's IS Office: ________________________________ Date: ___________ 

Approved: _________________________________________________ Date: ____________ 
                    James W. Hoekstra, M.D., 

                    Associate Dean, Clinical Education and Outreach,  College of Medicine and Public Health  


Technical issues should be addressed to the webmaster@www.med.ohio-state.edu
Questions? Contact Wasif Malik
(malik.42@osu.edu or 8-4106)