UPMC Purchase Order / Requisition Inquiry

Please complete the fields below. The asterisk (*) indicates mandatory fields.

Your inquiry is important to us.

Purchase Order # (if known):

Requisition #:

UPMC Requestor Name: *

A value is required.

UPMC Requestor Phone Number:

( ) -

Delivery Location: *

A value is required.

Request Date:

Submission Date: *
(todays date)

Description of Inquiry: *
(300 character limit)

A value is required.Exceeded maximum number of characters.
Characters left:

Supplier Company Name:

First Name: *

A value is required.

Last Name: *

A value is required.

E-mail Address: *

A value is required.Invalid format.

Confirm E-mail: *

A value is required.Invalid format.

Phone Number: *

( ) -