First Assistant Registration

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First Assistant Registration

FIRST ASSISTANT REGISTRATION

You’re less than 10 minutes away from applying online! Once you apply, a representative will contact you shortly.

* Indicates a required field

First Name *

Last Name *

Email Address *

Phone Number *

Street Address *

Street Address Line 2

City/Town *

State/Territory

Postal/Zip Code *

Country *

Current Occupation *

Years of experience in OR settings *

Will your clinical setting provide you with the following signatures ( two surgeons or one surgeon/one OR manager) after completing Surg 6600? *

Yes No

Do you have access to clinical setting for Surg 6600 (hands on case log)? *

Yes No

Are you a U.S. citizen or permanent resident? *

Yes No

How did you hear about us? *

Google or other search Word of mouth Advertisement Article or blog post Social media

Registration Process

Step 1: Apply Online for a student account and fill out the student registration form – A Surgical Skillz representative will contact you within 24 hours when you submit your application.

Step 2: Determine which tuition options works best for you

Step 3: Pay for course

Step 4: Sign Student Agreement Form

Step 5: Receive your login information

Step 6: Start taking classes

Please note that completing and submitting this form provides consent without obligation for Surgical Skillz Training to call, text, and/or email you by automated means about the First Assistant Online program at the number and/or email address listed.

American Board of Surgical Assistants Certification Requirement *

I have reviewed the American Board of Surgical Assistants certification requirements.

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502-802-7360

1945 Scottsville RD, B-2, PMB 116 Bowling Green, KY 42104-5817

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