Apply to Help Shape the Academy

We are inviting colleagues, Surgical Technology students, educators, and selected healthcare professionals to evaluate the program before its public launch. Honest feedback is the most important qualification.

FREE LIFETIME ACCESS FOR APPROVED PILOT MEMBERS

About You

Full name *

Email address *

Phone number

City and state

Current role *

Years of Surgical Technology experience

Your Robotic Surgery Background

Robotic surgery experience *

School, hospital, or organization

What would you most like to learn or improve?

Why would you like to join the pilot program? *

Pilot Participation

I agree to make a good-faith effort to complete the assigned pilot materials during the evaluation period. * I agree to provide honest, constructive feedback and report unclear content or technical issues. * I agree to be contacted with pilot instructions, reminders, and a final evaluation survey. After completing the program, I am open to being asked for a testimonial. This does not require me to provide one or to give positive feedback.

This educational program does not replace employer training, facility policy, manufacturer instructions, professional judgment, or supervised clinical education.

Return to Program Details

Your application is ready.
A text copy has been downloaded to your device. Send that file to the Academy using the contact method provided on the live website.

Website-owner note: this portable version does not store personal information on a server. When the site is published, connect the form to the Academy's secure form service or enrollment platform.