Education Request

This form is designed for employee education or compliance education requests. If you would like to make a request for academic education assistance, please send an email to Blackboard Support.

Requestor Information all fields required








Content Information * indicates required field

*Is this a request for new content or to update existing content?
*Is this an annual, ongoing, or single instance of a course?







Will Continuing Education credit be offered for this course? Check all that apply


*Is this content required?
If Yes, by whom? Enter all that apply
*Are there content or learning objects already in existence that are similar to your course, such as HIPAA training?


Request Media Assistance


Select the techonologies you would like to use for your learning:

PDF, Video, Link
Timeline: 1 - 2 weeks
Convert a PowerPoint presentation into a narrated video with optional practice or quiz questions.
Timeline: 2 - 4 weeks
Video vignettes, demonstrations, or commentaries.
Timeline: 4 - 8 weeks
Advanced interactions include simulations, branched scenarios, and/or games.
Timeline: 6 - 12 weeks
In which format(s) will the content be offered? Check all that apply





Target Audience Information all fields required

Audience Affiliation Check all that apply, at least one

Target Role Groups Check all that apply, at least one




Will a single training module be appropriate for all audiences?
Please provide supplementary material (i.e. additional modules, job aid documents, etc.) tailored for each department or target audience.
Is this content for new hires?


Content Details Please complete as much of this section as you can.








Do you have an attestation in this content?





Do you have any audio or video in this content?
If yes, does the audio/video contain closed captioning or a script we can include for ADA compliance?
Did you include your references/evidence-based practice on the last slide?
If not, please add them before submitting.

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