Forms - URMC Web Services - University of Rochester Medical Center

Forms are used throughout our site to request information, contact departments, sign up for newsletters, etc. To request a form, please submit a ticket. We will work with you to determine your requirements and build you a form that meets your needs.

For more information on usage and functionality, please read the Forms post in Slab.

Basic Form

Name First Name

Last Name

Address Street

City

State

Zip

Other Contact Information Email Address

Upload

Misc Radio Button List Horizontal

Option 1
Option 2
Option 3
Option 4

Radio Button List Vertical

Option 1Option 2Option 3Option 4

Our Privacy Policy

Dynamic Form

This is an example of a form with dynamic functionality, using jQuery and our form.js library. You can find out more about the Forms.js library in the Web Services wiki.

What would you like to do?:

Show SectionHide Section

Name First Name:

Last Name:

Show Below:

Show Below

Dynamic Field:

This field is only shown when the checkbox above is checked

Our Privacy Policy

Grid Form

Name First Name:

Email Address:

Last Name:

Address Street:

City:

State:

Zip:

Our Privacy Policy