The Johns Hopkins Medical Archives



The Johns Hopkins Medical Archives

Records Transmittal Form

This form is for the transmittal (transfer) of records to JHMI off-site Records Center managed by the Medical Archives.

Contact Information

|Department Name |      |

|Institution: |School of Public |Hospital      |School of Medicine      |School of Nursing      |

| |Health      | | | |

| |Other (specify)      |

|Staff Contact Name |      |

|Position |      |

|Mailing Address |      |

|Phone |      |

|Email |      |

|Billing Contact (if different) |Name      |Email      |Phone      |

|Internal Order/Cost Center Number|      |

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Record Information

|Date Range |(inclusive)      |

|Quantity |(Number of boxes and cubic feet)      |

|Record Series |(description on page 3)      |

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|File arrangement |(alpha by name, alpha by topic, chrono, file number)      |

|Record medium | (paper, microfilm, electronic, tape, film, etc. If digital, specify software, operating system, |

| |etc.) |

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|Series retention |      |

|Series disposal year |      |

|Condition of disposal |(shred, burn, etc):      |

|Terms and Conditions For Access |      |

Individual Box Content List (an Excel spreadsheet can be attached for the box list)

|Box Number |Records Center Locator Number | |Record Dates |

| |(RFID number) |Description of Records |Begin – End |

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|Archives Use |

|Received by: |Date received: |Accession Number: |Accession Date: |Status of records: |

|Function of records: |

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Instructions and Definitions

Record Information Form (The entire series of records being transferred to storage)

• Date Range: The inclusive date ranges of all the records (Mar. 1998 – Dec. 2006)

• Record series: 1. A group of similar records that are arranged according to a filing system and that are related as the result of being created, received, or used in the same activity; a file group; a record series. – 2. Bibliography · A group of items, each with its own title, also bearing a collective title for the group as a whole.[1]

Individual Box Content List

• Information on the contents of individual boxes being transferred into storage

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