Student Agreement Form

A. Surgical Skillz LLC Agrees To Provide:

1. Course/Program Title: First Assistant Online Program, Accelerated First Assistant Online Program, or Professional Exam
2. Course/Program Description Outline:
• A. SURG-6000 Surgical Anatomy: The Surgical Anatomy course is designed to provide accurate information about the structure and function of the human body. The course is planned for students who are pursuing a career as a surgical first assistant. Course instruction will relate anatomy to surgical techniques, develop an understanding of the disease processes, and the relationship of the processes to the specific types of pathologies according to body systems.
• B. SURG-6200 Surgical Basic Principles: The course is designed to introduce the student to the basic principles in surgical assisting. The course incorporates the history of surgery, ethics in surgery, molecular and cell biology, the role of cytokines as mediators of an inflammatory response, shock, electrolytes, fluid, hematologic principles in surgery, metabolism in surgical patients, wound healing, and critical assessment of surgical outcomes.
• C. SURG-6400 Perioperative Management: This course is designed to promote understanding in principles of preoperative/operative surgery, ultrasound for surgeons, surgical infections, choice of antibiotics, surgical problems in the immunosuppressed patient, surgical complications, surgery in the elderly, morbid obesity, anesthesia.
• D. SURG - 6600 Surgical First Assistant Clinical: In a clinical setting, the student will perform the duties of a surgical first assistant during surgical procedures. Clinicals are designed to provide the student with hands-on experience in a clinical setting. Performing the duties of a surgical assistant includes: positioning the patient, providing visualization of the operative site, utilizing appropriate techniques to assist with hemostasis, utilizing appropriate techniques in the closure of body planes, postoperative subcutaneous injection of local anesthetic agent as directed by the surgeon, selecting and applying appropriate wound dressings and securing drainage systems. The nature of the cases shall be varied according to the set standards for each certifying body. Surgical Skillz uses Surg-6600 as a tool to get hands-on training for their students; therefore, we recommend our students attain a minimum of 135 cases. SURG-6600 requires two signatures from one surgeon and one OR management member or two surgeons. These signatures are mandatory in order to complete SURG-6600. Surgical Skillz does not provide any assistance with this session.
3. Award: Certificate on program completion
4. Records: Surgical Skillz LLC will maintain a permanent record of the student’s training for 24 months after completion of program.

B. Student payment options:

1. Option 1: Paid in Full - receives a 30% discount for standard program which brings program total to $2,796.50 or 10% discount for accelerated program which brings program total to $3,595.50.
2. Option 2: $1,997.50 due at enrollment and the balance must be paid in full 90 days after first payment.

Student account will be placed on hold until balance obligations have been fulfilled.

3. Students must have all course requirements completed within 12 months. Students who have not completed course requirements must contact the program director for an extension. Extensions are for 6 months. The cost for an extension is $1,997.50 per request. Extensions are granted on a case-by-case basis. Therefore, it is not guaranteed an extension will be granted.

C. The parties (Surgical Skillz LLC and Student) agree that the following shall be essential terms and conditions of this Agreement:

1. The Student agrees to carry adequate public liability and other appropriate forms of insurance, to pay all taxes incident hereunto, and otherwise protect and hold Surgical Skillz harmless from any and all liability not specifically provided for in this Agreement.
2. The parties shall comply with all applicable Federal and State laws and regulations in the performance of this Agreement.
3. Either party may terminate this Agreement by giving written notice according to guidelines set by Refund Policy.

D. To be considered for a refund, a student must submit a written notice of withdrawal to the institution. Notices of dismissal to a student must also be in written form.

1. If written notice of withdrawal is received less than (3) calendar days after the contract was made, Surgical Skillz will return all funds paid except a $300 processing fee.
2. If written notice of withdrawal is received by Surgical Skillz (7) calendar days after starting the program of study, Surgical Skillz will retain 30% of the total fees paid under the contract.
3. If written notice of withdrawal is received by Surgical Skillz (10) calendar days after starting the program of study, Surgical Skillz will retain 50% of the total fees paid under the contract.
4. If a student withdraws after (15) days of starting the program of study, no refund will be given.
5. If a student is dismissed from program, no refund will be given.

E. Payment Terms:

1. All payments are due on the1st of each month
2. Students have 10 days for payment to be received by Surgical Skillz before it is considered late
3. Payments received after 10 days, student's account will incur $50 late fee
4. Payments received after 30 days, student's account will incur $100 late fee
5. All payments using checks, money orders, credit cards, or any other method resulting in non-sufficient funds (NSF) will incur $100 fee on student's account
6. Student's account will automatically be placed on hold after 2nd NSF and student's account balance must be paid in full to continue program
7. Student accounts that have been placed on hold have 30 days after being placed on hold to pay balance in full. Students that fail to pay the balance in full 30 days after being placed on hold will forfeit all funds paid for program
8. The Student is not permitted to video/audio tape or copy/share/download the instructions of the course unless prior negotiations between the Student and the Institution have been completed
9. STUDENT acknowledgement of said agreement by registering for Surgical Skillz First Assistant Online program

F. To ensure student integrity, students who fail the exam/quiz a second time will be required to pay a $300 reset fee. All exams/quizzes must receive a passing score before the student can proceed in the course.

G. Surgical Skillz First Assistant Program is approved by the American Board of Surgical Assistants (ABSA) as a Surgical Assistant Training Program.

H. Surgical Skillz does not facilitate or guarantee the following: clinical rotation, job placement, certification, or hospital recognition of training.

I. Surgical Skillz students will sit for the national certification exam with the American Board of Surgical Assistants once program has been successfully completed and have met all requirements established by ABSA.

J. Surgical Skillz does not contract or provide agreements with facilities for student hands-on training or program approval. Students are solely responsible for answering yes for the following two questions:

1. Will your clinical setting provide you with the following signatures (two surgeons or one surgeon/one OR manager) after completing Surg 6600?
2. Do you have access to clinical setting for Surg 6600 (hands on case log)?

K: SAME as CASH

Same as Cash Accelerated Program (Balance must be paid in full within 12 months from enrollment date. There will be a late fee of $1997.50 charge after 12 months.)