  The use of quasi-elastic electron nucleus scattering is shown to provide
significant constraints on models of the proton electromagnetic form factor of
off-shell nucleons. Such models can be constructed to be consistent with
constraints from current conservation and low-energy theorems, while also
providing a contribution to the Lamb shift that might potentially resolve the
proton radius puzzle in muonic hydrogen. However, observations of quasi-elastic
scattering limit the overall strength of the off-shell form factors to values
that correspond to small contributions to the Lamb shift.
