University of Kentucky Medical Center - Physical Plant Division

Work Order Request Form

This is the Medical Center Physical Plant Division [PPDMC] Work Order form. You are responsible for entering, reviewing,and submitting the necessary information for processing this form. If you need help filling out this form, you may contact the PPDMC Dispatch office at 3-6281.

Customer Information: (Required information is in RED)

Last Name:
First Name:
Phone Number:
Email Address:
Department:
Building:
Room Number:


Work Order Location
Building:
Floor:
Room Prefix:
Room Number:


Work Order Description
Description of work to be performed:



Work Order Category
	Maintenance
	Charge to Service Contract
	Charge to Account

SAP Account Number:


Work Order Priority
	General Maintenance
	Daily Operation
	Elective Improvement
	Patient Care/Safety
	Emergency


Desired Completion Date:


Is this a call back? Yes No


Comments:

Please review the information you entered and submit the form.