Website Request Form

Please complete the form below if you would like to request a new website within the Faculty of Medicine.

If you are not associated with the Faculty of Medicine, please request a website from the Centre for Teaching, Learning & Technology using their website request form.

Note: Individuals, student groups and non-UBC organizations are NOT eligible for the CLF.
Contact Information
Name*
First Last
Phone*
Email*
What is your job title or role?*
Will you be the primary contact/administrator for the website?*
- Yes
- No
Primary contact/administrator's name*
First Last
Primary contact/administrator's email address*
Website Details
What is the title of your website?*
Which department, school, research institute, centre or program does your unit fall under?*
Requested domain name (Note: the subdomain will be .med.ubc.ca)*
What is the purpose of your website?*
Who is your target audience?*
Please provide examples of content that will be on your website:*
Will the website include teaching and/or learning materials (e.g., teaching resources, lecture materials, quizzes)?*
- Yes
- No
Will the website include password-protected content?*
- Yes
- No
Please enter any other features your website requires (e.g., calendar, profiles):
Do you have a current website or other online presence such as social media?*
- Yes
- No
Please enter any URLs to your existing online presence(s), one per line:*
Unit Contact Information
This information will be shown publicly in the footer of your website.
Unit Address*
Street Address Address Line 2 City Province Postal Code
Unit Phone*
Unit Email Address*
Unit Fax Number
Comments
This field is for validation purposes and should be left unchanged.

Contact Information

Website Details

Unit Contact Information