Carnegie Mellon University

Lactation Room Request for Access Form

Lactation room requests should be processed within two business days of receipt. Completion of this form will grant access to all lactation rooms that require card swipes. Lactation rooms are to be used for the sole purpose of expressing milk. If rooms are found to be used by individuals requesting access for purposes other than that listed here, access may be revoked. Please contact Equal Opportunity Services at eos@andrew.cmu.edu or 412-268-3386 with questions.

Visitors: Complete this form with your information and include your CMU Sponsor's Andrew ID. Indicate in the Comments field the approximate dates you will need access. Access cards can be picked up at the Cohon University Center Equipment Desk or at the Human Resources office at 143 North Craig Street. You must return access cards after the designated period of use.

Name

Email

Phone Number

Andrew ID (Faculty, Staff, Student, or Visitor's Sponsor)

Badge Number
(Your nine-digit badge number can be found on your ID card and begins with "82.")

Affiliation (Faculty, Staff, Student or Visitor)

Department

Sponsor's Name (for Visitors Only) 

Is there a room that you plan on primarily using? (CUC 267, Gates 8214, INI 4616 Henry Room 213, Mellon Institute 210A, Posner Hall (Tepper) A50E, PPG 6 - 14th Floor, Wean 4432)
(Note that you will be granted card swipe access to CUC, Gates, INI, Tepper, and Wean Hall. The other rooms are left open for use.)

Anticipated First Date of Use
(Access will be reviewed at six months and one year from this date)

If you have any additional comments or questions regarding lactation space or access, please list below. VISITORS: Please include dates of use in this field.