| Total MD's (all categories) | |
| Total FTE's (Check with your payroll department) | |
| Total Discharges | |
| Out Patient Visits | |
| Patient Days | |
| Does institution have Medical Post Graduate Training Positions? | Y / N |
| Does institution have other Post Graduate Training Positions? | Y / N |
| Does institution have a School of Nursing? | Y / N |
| Does institution have a School of Allied Health | Y / N |
| Are medical students affiliated with the Institution? | Y / N |
| FTE MLS in Library | |
| Total # Library FTE's | |
| Collections | |
| # of Monographs Added Annually | |
| # of Current Journal Subscriptions | |
| Total Collection Size (include # books + # journal volumes + # AV's + # other formats) | |
| Information Services | |
| # Reference Questions | |
| # Mediated Searches | |
| # Enduser Searches | |
| InterLibrary Loan Services | |
| Total # Borrowed | |
| Total # Loaned | |
| Circulation | |
| # Monographs | |
| # Journals | |
| # Media | |
| # AV Equipment | |
| Shelving | |
| # Monographs | |
| # Journals | |
| # Media | |
| # AV Equipment | |
| Photocopy Service | |
| Does your library provide copy service? | Y / N |
| To whom do you provide copy service? | |
| Total # pages library copy service provides annually? | |
| Total # copy requests library copy service fills annually? | |
| Does your library provide self-service copying? | Y / N |
| Does your library charge for self-service copying? | Y / N |
| Total # pages generated by self-service copying? | |
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