Participant Registration Please use this form to create a participant account only. To create a proctor or admin account, please contact [email protected] Are you part of the Fellowship Council Pilot? Yes No Name(Required) First Last Email(Required)This will become your login username. Please consider using a non-institutional email for maximum control. Create Password(Required) Enter Password Confirm Password Strength indicator Current Institution(Required)Please select the best match for your current position(Required) Student Resident Fellow Attending Med School Year(Required)PG Year(Required)Year in Practice(Required)Student Type(Required) Medical PA Other Resident Type(Required) General Surgery GYN Urology Other Fellow Type(Required) MIS Bariatric/Foregut Colorectal HPB Gyn Urology Other Did you do an MIS/Bariatric Fellowship?(Required) Yes No Are you FLS Certified Yes No Approximate Date of FLS CertificationConsent(Required)ATLAS is intended to teach and assess advanced laparoscopic suturing skills for laparoscopic and robotic surgery. All persons uploading performance data will do so voluntarily for the purpose of benchmarking performance, research and quality improvement. Only accurately collected data will be accepted. The ATLAS program reserves the right to investigate the authenticity of submitted data and suspend any account that is felt to be submitting inaccurate of falsified data. All publicly reported data will be deidentified prior to being reported by the ATLAS program for research and quality improvement. Requests for data for research and performance improvement can be made to the ATLAS program and will be considered on an individual basis. I agree to the terms and conditions of the ATLAS projectAdditional Demographics for FC Pilot ParticipantsNameThis field is for validation purposes and should be left unchanged.
